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Giant Cell Arteritis Presenting as Cholestatic Hepatitis
BACKGROUND: Severely deranged liver function tests (LFTs) are an atypical presentation of giant cell arteritis (GCA). Atypical presentations of GCA may result in missed or delayed diagnosis. This increases the risk of visual loss, the most feared outcome of GCA. Our patient presented with significan...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463243/ https://www.ncbi.nlm.nih.gov/pubmed/34567812 http://dx.doi.org/10.1155/2021/4455748 |
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author | Riordan, Gerald Riordan, John |
author_facet | Riordan, Gerald Riordan, John |
author_sort | Riordan, Gerald |
collection | PubMed |
description | BACKGROUND: Severely deranged liver function tests (LFTs) are an atypical presentation of giant cell arteritis (GCA). Atypical presentations of GCA may result in missed or delayed diagnosis. This increases the risk of visual loss, the most feared outcome of GCA. Our patient presented with significant cholestatic derangement of his LFTs with a peak alkaline phosphatase level (ALP) of 3091 IU/L, which is the highest published level for patients with GCA. Case Presentation. Our patient was investigated for abnormal LFTs associated with sinus pain, fevers, and a dry cough. Bilateral temporal artery biopsies confirmed GCA. His symptoms and LFTs improved with corticosteroids. CONCLUSION: This is an unusual presentation of GCA and highlights the need to consider GCA in patients with unexplained cholestatic LFT abnormalities. |
format | Online Article Text |
id | pubmed-8463243 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-84632432021-09-25 Giant Cell Arteritis Presenting as Cholestatic Hepatitis Riordan, Gerald Riordan, John Case Reports Hepatol Case Report BACKGROUND: Severely deranged liver function tests (LFTs) are an atypical presentation of giant cell arteritis (GCA). Atypical presentations of GCA may result in missed or delayed diagnosis. This increases the risk of visual loss, the most feared outcome of GCA. Our patient presented with significant cholestatic derangement of his LFTs with a peak alkaline phosphatase level (ALP) of 3091 IU/L, which is the highest published level for patients with GCA. Case Presentation. Our patient was investigated for abnormal LFTs associated with sinus pain, fevers, and a dry cough. Bilateral temporal artery biopsies confirmed GCA. His symptoms and LFTs improved with corticosteroids. CONCLUSION: This is an unusual presentation of GCA and highlights the need to consider GCA in patients with unexplained cholestatic LFT abnormalities. Hindawi 2021-09-17 /pmc/articles/PMC8463243/ /pubmed/34567812 http://dx.doi.org/10.1155/2021/4455748 Text en Copyright © 2021 Gerald Riordan and John Riordan. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Riordan, Gerald Riordan, John Giant Cell Arteritis Presenting as Cholestatic Hepatitis |
title | Giant Cell Arteritis Presenting as Cholestatic Hepatitis |
title_full | Giant Cell Arteritis Presenting as Cholestatic Hepatitis |
title_fullStr | Giant Cell Arteritis Presenting as Cholestatic Hepatitis |
title_full_unstemmed | Giant Cell Arteritis Presenting as Cholestatic Hepatitis |
title_short | Giant Cell Arteritis Presenting as Cholestatic Hepatitis |
title_sort | giant cell arteritis presenting as cholestatic hepatitis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463243/ https://www.ncbi.nlm.nih.gov/pubmed/34567812 http://dx.doi.org/10.1155/2021/4455748 |
work_keys_str_mv | AT riordangerald giantcellarteritispresentingascholestatichepatitis AT riordanjohn giantcellarteritispresentingascholestatichepatitis |