Volume : 4, Issue : 4, April - 2015

Giant cell arteritis with internal carotid artery stenosis and third nerve palsy: a case report

M. Moghaddasi, Faouzya Benaissa, N. Mohebi, L. Hashami, H. Karimian, A. Rast Manesh

Abstract :

<p>&lt;p&gt;&amp;nbsp;Background:&lt;/p&gt; &lt;div&gt;Giant cell arteritis or temporal arteritis is a necrotizing medium to large vessel arteritis of unknown etiology that was&amp;nbsp;&lt;/div&gt; &lt;div&gt;firstdescribed in 1932 by Horton. It commonly afflicts elderly people and may present with diverse manifestations such as severe headache,&amp;nbsp;&lt;/div&gt; &lt;div&gt;impairment of vision,ophtalmoplegia, polymyalgia rheumatica, tenderness of the temporal arteries, a highly elevated erythrocyte sedimentation&amp;nbsp;&lt;/div&gt; &lt;div&gt;rate (ESR) and a characteristic abnormal temporal artery biopsy.&lt;/div&gt; &lt;div&gt;Case report:&lt;/div&gt; &lt;div&gt;We report a 67&amp;ndash;year&amp;ndash;old man with new onset temporal headache, moderately elevated ESR, cranial nerves palsy, and high grade internal carotid&amp;nbsp;&lt;/div&gt; &lt;div&gt;artery stenosis, who was finally diagnosed as giant cell arteritis, although temporal artery biopsy was normal.&lt;/div&gt; &lt;div&gt;Discussion:&lt;/div&gt; &lt;div&gt;We conclude that, giant cell arteritis should be considered in all patients (even in those with ESR &amp;lt;50 and negative biopsy) presenting with third&amp;nbsp;&lt;/div&gt; &lt;div&gt;nerve palsy and temporal artery related symptoms or signs.&lt;/div&gt;</p>