Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder

Muhammad Raza Cheema, Shakawan M IsmaeelGeriatrics Department, Wirral University Teaching Hospital, Merseyside, United KingdomAbstract: Temporal arteritis, also known as giant cell arteritis (GCA), is a systemic vasculitis that predominantly involves the temporal arteries. It is a medical emergency...

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Auteurs principaux: Cheema MR, Ismaeel SM
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Langue:EN
Publié: Dove Medical Press 2016
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spelling oai:doaj.org-article:acbfee0262074cc6b8c54725d6acac1d2021-12-02T05:56:42ZTemporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder1178-1998https://doaj.org/article/acbfee0262074cc6b8c54725d6acac1d2016-02-01T00:00:00Zhttps://www.dovepress.com/temporal-arteritis-with-erythrocyte-sedimentation-rate-lt50nbspmmh-a-c-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Muhammad Raza Cheema, Shakawan M IsmaeelGeriatrics Department, Wirral University Teaching Hospital, Merseyside, United KingdomAbstract: Temporal arteritis, also known as giant cell arteritis (GCA), is a systemic vasculitis that predominantly involves the temporal arteries. It is a medical emergency and should be treated promptly as it can lead to permanent loss of vision. It is very commonly associated with a raised erythrocyte sedimentation rate (ESR), usually >50 mm/h, one of the essential criteria defined by the American College of Rheumatology classification of GCA. Here, we describe the case of a 73-year-old male presenting with a 2-day history of a sudden onset of a severe left-sided headache, which had the signs and symptoms consistent with GCA but he had an ESR of only 27 mm/h. The patient was urgently treated with prednisolone 60 mg per day, and his symptoms dramatically improved within 24 hours of therapy. Temporal artery biopsy results were consistent with an inflammatory response, and withdrawal of treatment led to a relapse of the symptoms. The patient was slowly tapered off the high steroid dose and is now currently managed on a low steroid dose. We should keep a high index of suspicion for GCA in patients presenting with clinical symptoms of GCA even though the ESR is <50 mm/h as stated in the criteria for GCA diagnosis.Keywords: temporal arteritis, giant cell arteritis, prednisolone, erythrocyte sedimentation rateCheema MRIsmaeel SMDove Medical PressarticleTemporal ArteritisGiant Cell ArteritisPrednisoloneErythrocyte sedimentation rate (ESR).GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 11, Pp 185-188 (2016)
institution DOAJ
collection DOAJ
language EN
topic Temporal Arteritis
Giant Cell Arteritis
Prednisolone
Erythrocyte sedimentation rate (ESR).
Geriatrics
RC952-954.6
spellingShingle Temporal Arteritis
Giant Cell Arteritis
Prednisolone
Erythrocyte sedimentation rate (ESR).
Geriatrics
RC952-954.6
Cheema MR
Ismaeel SM
Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
description Muhammad Raza Cheema, Shakawan M IsmaeelGeriatrics Department, Wirral University Teaching Hospital, Merseyside, United KingdomAbstract: Temporal arteritis, also known as giant cell arteritis (GCA), is a systemic vasculitis that predominantly involves the temporal arteries. It is a medical emergency and should be treated promptly as it can lead to permanent loss of vision. It is very commonly associated with a raised erythrocyte sedimentation rate (ESR), usually >50 mm/h, one of the essential criteria defined by the American College of Rheumatology classification of GCA. Here, we describe the case of a 73-year-old male presenting with a 2-day history of a sudden onset of a severe left-sided headache, which had the signs and symptoms consistent with GCA but he had an ESR of only 27 mm/h. The patient was urgently treated with prednisolone 60 mg per day, and his symptoms dramatically improved within 24 hours of therapy. Temporal artery biopsy results were consistent with an inflammatory response, and withdrawal of treatment led to a relapse of the symptoms. The patient was slowly tapered off the high steroid dose and is now currently managed on a low steroid dose. We should keep a high index of suspicion for GCA in patients presenting with clinical symptoms of GCA even though the ESR is <50 mm/h as stated in the criteria for GCA diagnosis.Keywords: temporal arteritis, giant cell arteritis, prednisolone, erythrocyte sedimentation rate
format article
author Cheema MR
Ismaeel SM
author_facet Cheema MR
Ismaeel SM
author_sort Cheema MR
title Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
title_short Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
title_full Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
title_fullStr Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
title_full_unstemmed Temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
title_sort temporal arteritis with erythrocyte sedimentation rate <50 mm/h: a clinical reminder
publisher Dove Medical Press
publishDate 2016
url https://doaj.org/article/acbfee0262074cc6b8c54725d6acac1d
work_keys_str_mv AT cheemamr temporalarteritiswitherythrocytesedimentationratelt50nbspmmhaclinicalreminder
AT ismaeelsm temporalarteritiswitherythrocytesedimentationratelt50nbspmmhaclinicalreminder
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