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Giant Cell Arteritis: A Case With Unusual Neurologic Manifestations and a Normal Sedimentation Rate

Giant Cell Arteritis: A Case With Unusual Neurologic Manifestations and a Normal Sedimentation Rate Abstract Giant cell (temporal) arteritis is a serious inflammatory condition that can lead to blindness, stroke, or other adverse sequelae if not properly treated. An elevated erythrocyte sedimentation rate has traditionally been emphasized as a criterion for making this diagnosis. Delays in diagnosis and unnecessary testing may occur when a patient presents with a normal erythrocyte sedimentation rate and a clinical history consistent with this condition. We describe a patient with giant cell arteritis who presented with a normal erythrocyte sedimentation rate and who subsequently developed devastating central nervous system complications. (Arch Intern Med. 1991;151:378-380) References 1. Hollenhorst RW, Brown JR, Wagener HP, et al. Neurologic aspects of temporal arteritis . Neurology. 1960;10:490-498.Crossref 2. Caselli RJ, Hunder GG, Whisnat JP. Neurologic disease in biopsy-proven giant cell (temporal) arteritis . Neurology. 1988;38:352-359.Crossref 3. Mehler MF, Rabinowich L. The clinical neuro-ophthalmologic spectrum of temporal arteritis . Am J Med. 1988;85:839-844.Crossref 4. Wilkinson IM, Russell RW. Arteries of the head and neck in giant cell arteritis: a pathological study to show the pattern of arterial involvement . Arch Neurol. 1972;27:378-391.Crossref 5. Enzmann D, Scott WR. Intracranial involvement of giant cell arteritis . Neurology. 1977;27:794-797.Crossref 6. Hirsch M, Mayersdorf A, Lehmann E. Cranial giant cell arteritis . Br J Radiol. 1974;47:503-506.Crossref 7. Small P. Giant cell arteritis presenting as a bilateral stroke . Arthritis Rheum. 1984;27:819-821.Crossref 8. Jacobson DM, Slamovits TL. Erythrocyte sedimentation rate and its relationship to hematocrit in giant cell arteritis . Arch Ophthalmol. 1987;105:965-967.Crossref 9. Ellis ME, Ralston S. The ESR in the diagnosis and management of the polymyalgia rheumatica/giant cell arteritis syndrome . Ann Rheum Dis. 1983;42:168-170.Crossref 10. Roth AM, Milson L, Keltner JL. The ultimate diagnosis of patients undergoing temporal artery biopsies . Arch Ophthalmol. 1984;102:901-903.Crossref 11. Mallya RK, Hind CR, Berry H, Pepys MB. Serum C-reactive protein in polymyalgia rheumatica . Arthritis Rheum. 1985;28:383-387.Crossref 12. Jones JG, Hazelman BL. ESR in polymyalgia rheumatica and giant cell arteritis . Ann Rheum Dis. 1983;42:702-703.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Giant Cell Arteritis: A Case With Unusual Neurologic Manifestations and a Normal Sedimentation Rate

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400020122024
Publisher site
See Article on Publisher Site

Abstract

Abstract Giant cell (temporal) arteritis is a serious inflammatory condition that can lead to blindness, stroke, or other adverse sequelae if not properly treated. An elevated erythrocyte sedimentation rate has traditionally been emphasized as a criterion for making this diagnosis. Delays in diagnosis and unnecessary testing may occur when a patient presents with a normal erythrocyte sedimentation rate and a clinical history consistent with this condition. We describe a patient with giant cell arteritis who presented with a normal erythrocyte sedimentation rate and who subsequently developed devastating central nervous system complications. (Arch Intern Med. 1991;151:378-380) References 1. Hollenhorst RW, Brown JR, Wagener HP, et al. Neurologic aspects of temporal arteritis . Neurology. 1960;10:490-498.Crossref 2. Caselli RJ, Hunder GG, Whisnat JP. Neurologic disease in biopsy-proven giant cell (temporal) arteritis . Neurology. 1988;38:352-359.Crossref 3. Mehler MF, Rabinowich L. The clinical neuro-ophthalmologic spectrum of temporal arteritis . Am J Med. 1988;85:839-844.Crossref 4. Wilkinson IM, Russell RW. Arteries of the head and neck in giant cell arteritis: a pathological study to show the pattern of arterial involvement . Arch Neurol. 1972;27:378-391.Crossref 5. Enzmann D, Scott WR. Intracranial involvement of giant cell arteritis . Neurology. 1977;27:794-797.Crossref 6. Hirsch M, Mayersdorf A, Lehmann E. Cranial giant cell arteritis . Br J Radiol. 1974;47:503-506.Crossref 7. Small P. Giant cell arteritis presenting as a bilateral stroke . Arthritis Rheum. 1984;27:819-821.Crossref 8. Jacobson DM, Slamovits TL. Erythrocyte sedimentation rate and its relationship to hematocrit in giant cell arteritis . Arch Ophthalmol. 1987;105:965-967.Crossref 9. Ellis ME, Ralston S. The ESR in the diagnosis and management of the polymyalgia rheumatica/giant cell arteritis syndrome . Ann Rheum Dis. 1983;42:168-170.Crossref 10. Roth AM, Milson L, Keltner JL. The ultimate diagnosis of patients undergoing temporal artery biopsies . Arch Ophthalmol. 1984;102:901-903.Crossref 11. Mallya RK, Hind CR, Berry H, Pepys MB. Serum C-reactive protein in polymyalgia rheumatica . Arthritis Rheum. 1985;28:383-387.Crossref 12. Jones JG, Hazelman BL. ESR in polymyalgia rheumatica and giant cell arteritis . Ann Rheum Dis. 1983;42:702-703.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1991

References