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An interesting case of temporal arteritis that manifested as ptosis and diplopia

Giant cell arteritis (GCA) or temporal arteritis is a granulomatous vasculitis that affects medium-to-large vessels seen primarily in older Caucasian populations. Here, we describe a 67-year-old male who presented with atypical symptoms of worsening headaches associated with left-sided pupil-sparing...

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Detalles Bibliográficos
Autores principales: Martis, Anoka, Hassan, Romesa Sajjad, Alburquerque, Ana Goico, Kotte, Manasa, Martis, Anshu, Ahmed, Hassan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685022/
https://www.ncbi.nlm.nih.gov/pubmed/33269083
http://dx.doi.org/10.1093/omcr/omaa099
Descripción
Sumario:Giant cell arteritis (GCA) or temporal arteritis is a granulomatous vasculitis that affects medium-to-large vessels seen primarily in older Caucasian populations. Here, we describe a 67-year-old male who presented with atypical symptoms of worsening headaches associated with left-sided pupil-sparing, isolated third nerve palsy, blurry vision, diplopia and myalgias in bilateral extremities. He was immediately started on intravenous Methylprednisolone for suspected GCA. Subsequent biopsy of the temporal arteries showed panarteritis without giant cells and disruption of the internal elastic lamina. His symptoms improved in a day following treatment and he was discharged on a Prednisone taper. At the time of writing this case, there are only two cases in the literature of ptosis as a presenting symptom in GCA, thus highlighting the importance of recognizing rare red flag symptoms such as ptosis and diplopia. More study is needed in the prognostic significance of these unusual clinical features.