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

António Mesquita; Lara Camara; Catarina Patrício; Vítor Brotas

doi:10.1136/bcr-2019-232234

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

António Mesquita, Lara Camara, Catarina Patrício, Vítor Brotas

NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)

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Abstract

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 language	English
Article number	e232234
Journal	BMJ case reports
Volume	13
Issue number	3
DOIs	https://doi.org/10.1136/bcr-2019-232234
Publication status	Published - 25 Mar 2020

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title = "Boundaries of a systemic disease: a protean presentation of giant cell arteritis",

abstract = "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.",

author = "Ant{\'o}nio Mesquita and Lara Camara and Catarina Patr{\'i}cio and V{\'i}tor Brotas",

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AU - Mesquita, António

AU - Camara, Lara

AU - Patrício, Catarina

AU - Brotas, Vítor

PY - 2020/3/25

Y1 - 2020/3/25

N2 - 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.

AB - 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.

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JO - BMJ case reports

JF - BMJ case reports

IS - 3

M1 - e232234

ER -

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

Abstract

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