title: Multifocal VZV vasculopathy with temporal artery infection mimics giant cell arteritis.
abstract: OBJECTIVE
  To address the incidence of varicella-zoster virus (VZV) infection in patients with biopsy-negative giant cell arteritis (GCA), we examined archived biopsy-negative temporal arteries from subjects with clinically suspected GCA for the presence of VZV antigen.
  
  
  METHODS
  Formalin-fixed, paraffin-embedded temporal arteries that were pathologically negative for GCA and normal temporal arteries were analyzed immunohistochemically for VZV and herpes simplex virus-1 (HSV-1) antigen.
  
  
  RESULTS
  Five (21%) of 24 temporal arteries from patients who were clinically suspect but biopsy negative for GCA revealed VZV but not HSV-1 by immunohistochemical analysis. Thirteen normal temporal arteries did not contain VZV or HSV-1 antigen. All 5 subjects whose temporal arteries contained VZV antigen presented with clinical and laboratory features of GCA and early visual disturbances.
  
  
  CONCLUSIONS
  Multifocal VZV vasculopathy can present with the full spectrum of clinical features and laboratory abnormalities characteristically seen in GCA.
authors: Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
authors: Maria A
authors: MA
authors: Nagel
authors: Jeffrey L
authors: JL
authors: Bennett
authors: Nelly
authors: N
authors: Khmeleva
authors: Alexander
authors: A
authors: Choe
authors: April
authors: A
authors: Rempel
authors: Philip J
authors: PJ
authors: Boyer
authors: Don
authors: D
authors: Gilden
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000473:pathology* / Q000821:virology*; D006562:Herpes Zoster / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014645:Herpesvirus 3, Human / Q000472:pathogenicity*; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D013699:Temporal Arteries / Q000473:pathology* / Q000821:virology*; D014652:Vascular Diseases / Q000175:diagnosis / Q000473:pathology* / Q000821:virology*
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