title: Giant cell arteritis exclusively detected by 18F-fluorodeoxyglucose positron emission tomography: a case report.
abstract: BACKGROUND
  This case of giant cell arteritis is noteworthy because it evaded standard diagnostic criteria and only emerged as fever of unknown origin. In this regard, we present 18F-fluorodeoxyglucose positron emission tomography as a valid diagnostic method.
  
  
  METHODS
  This case report describes a 58-year-old Caucasian woman who is a cigarette smoker with a 10-week history of fever of unknown origin, night sweats and weight loss of 12 kg. Initially, clinical presentation was suspicious of malignant disease. Laboratory findings detected significantly elevated inflammatory blood parameters including C-reactive protein and elevated erythrocyte sedimentation rate (110 mm/hour). Extensive diagnostic workup including microbiological and rheumatological assessment, ultrasonography, endoscopy and computed tomography of abdomen and thorax did not indicate any septic or malignant focus. Eventually, 18F-fluorodeoxyglucose positron emission tomography was able to reveal arteritis of her aortic arch and supraaortic branches. Subsequently, she commenced steroid and methotrexate therapy that led to sustained remission.
  
  
  CONCLUSIONS
  This case of giant cell arteritis may promote discussion regarding a more specific classification for this disease entity. Furthermore, it confirms that 18F-fluorodeoxyglucose positron emission tomography might serve as a valuable tool for diagnosis of giant cell arteritis, because it could facilitate an accurate and non-invasive detection of lesions of large vessels.
authors.affiliation: Department of Medicine B, University of Münster, Albert-Schweitzer-Campus 1, D-48129 Münster, Germany. markus.brueckner@ukmuenster.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Brückner
authors.forename: Dominik
authors.initials: D
authors.lastname: Bettenworth
authors.forename: Karin
authors.initials: K
authors.lastname: Hengst
authors.forename: Matthias
authors.initials: M
authors.lastname: Weckesser
authors.forename: Peter
authors.initials: P
authors.lastname: Willeke
authors.forename: Jan
authors.initials: J
authors.lastname: Heidemann
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging*; D006801:Humans; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging / Q000379:methods
chemical_list: D019788:Fluorodeoxyglucose F18