Giant cell arteritis

Case contributed by Dr Enrico Citarella

Presentation

Temporal region bilateral pain. Visual impairment. Raised serum erythrocyte sedimentation rate (ESR) and serum C reactive protein (CRP). Follow up after steroid therapy.

Patient Data

Age: 74
Gender: Female

Baseline ultrasound study

Modality: Ultrasound

Bilateral diffuse thickening of the temporal arterial wall which appears hypoechoic. The vessel course is quite tortuous.

Follow up ultrasound study 40 days later after steroid therapy.

Modality: Ultrasound

Lesser evidence of the temporal arterial wall which is also less hypoechoic. Vessel's course is still quite tortuous.

PW exam shows a normal flow with well represented diastolic component.

Case Discussion

After steroid therapy (prednisone 50 mg/die) follow up study shows a substantial reduction of the arterial wall thickening and hypoechogenicity due to flogosis.

Serum erythrocyte sedimentation rate (ESR) and serum C reactive protein (CRP) lowered into normal ranges. Symptoms (temporal pain and visual impairment) reduced too.

Unfortunately biopsy was not performed, so diagnosis is to be considered presumptive.

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Case Information

rID: 35675
Case created: 15th Apr 2015
Last edited: 9th Sep 2015
System: Vascular
Inclusion in quiz mode: Excluded

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