Boundaries of a systemic disease: a protean presentation of giant cell arteritis

António Mesquita, Lara Camara, Catarina Patrício, Vítor Brotas

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1 Citation (Scopus)


A 60-year-old man was hospitalised with persistent fever, arm pain, dry cough and cholestasis. Diagnostic workup was remarkable for elevated inflammatory markers. Infectious diseases and autoimmune screening were negative. Imaging modalities excluded a neoplastic aetiology. Liver biopsy was negative for granulomatous or lymphomatous infiltrations. Giant cell arteritis (GCA) was suspected, but temporal artery Doppler ultrasound and biopsy were non-diagnostic. A positron emission tomography scan showed intense metabolic uptake in large vessels suggesting the diagnosis of GCA. Prednisolone was initiated with clinical and analytical improvement. At 1-year follow-up, there were no relapses and the patient remains symptom free.

Original languageEnglish
Article numbere232234
JournalBMJ case reports
Issue number3
Publication statusPublished - 25 Mar 2020


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