Giant Cell Arteritis with Choroidal Infarction

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Identifier Giant_Cell_Arteritis_with_Choroidal_Infarction
Title Giant Cell Arteritis with Choroidal Infarction
Creator Aretha Zhu; Kareem Moussa; Tina Zeng; Yin Allison Liu
Affiliation (AZ) Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School; (KM) Department of Ophthalmology, University of California, Davis; (TM) Department of Ophthalmology, University of California, Davis; (YAL) Departments of Ophthalmology, Neurology, and Neurological Surgery, University of California, Davis
Subject Choroidal Infarction; Erythrocyte Sedimentation Rate, Giant Cell Arteritis; Headache; Jaw Claudication; Painless Vision Loss; Rheumatology; Temporal Artery Biopsy; Vasculitis
Description The presentation describing a case of giant cell arteritis (GCA) with choroidal infarction documents an 83-year-old male experiencing recurring episodes of vision loss, predominantly manifesting as a "graying" of vision in both eyes, associated with new-onset headaches. The individual presented to the emergency department a year after symptom onset with a left eye supraduction deficit. Subsequent imaging revealed small aneurysms in the PCOM and ICA. Persistent bilateral visual deficits prompted a revisit to the ED a month later. Despite the absence of classical symptoms like jaw claudication, scalp tenderness, weight loss, or joint pain, the patient's positive findings of grade II APD and elevated ESR warranted an evaluation for GCA. The patient was started on oral prednisone at 60mg/day, and GCA was confirmed via temporal artery biopsy. We include a discussion of the diagnosis, differential, presentation, management, workup, prognosis, and complications of GCA.
Date 2023-11
References Gonzalez-Gay MA, Barros S, Lopez-Diaz MJ, Garcia-Porrua C, Sanchez-Andrade A, Llorca J. Giant cell arteritis: disease patterns of clinical presentation in a series of 240 patients. Medicine (Baltimore). 2005 Sep;84(5):269-276. doi: 10.1097/01.md.0000180042.42156.d1. PMID: 16148727. Koster MJ, Matteson EL, Warrington KJ. Large-vessel giant cell arteritis: diagnosis, monitoring and management. Rheumatology (Oxford). 2018 Feb 1;57(suppl_2):ii32-ii42. doi: 10.1093/rheumatology/kex424. PMID: 29982778. Ponte C, Grayson PC, Robson JC, Suppiah R, Gribbons KB, Judge A, Craven A, Khalid S, Hutchings A, Watts RA, Merkel PA, Luqmani RA; DCVAS Study Group. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Ann Rheum Dis. 2022 Dec;81(12):1647-1653. doi: 10.1136/ard-2022-223480. Epub 2022 Nov 9. Erratum in: Ann Rheum Dis. 2023 Feb;82(2):e52. PMID: 36351706. Gonzalez-Gay MA, Martinez-Dubois C, Agudo M, Pompei O, Blanco R, Llorca J. Giant cell arteritis: epidemiology, diagnosis, and management. Curr Rheumatol Rep. 2010 Dec;12(6):436-42. doi: 10.1007/s11926-010-0135-9. PMID: 20857242. Koster MJ, Matteson EL, Warrington KJ. Large-vessel giant cell arteritis: diagnosis, monitoring and management. Rheumatology (Oxford). 2018 Feb 1;57(suppl_2):ii32-ii42. doi: 10.1093/rheumatology/kex424. PMID: 29982778. Régent A, Mouthon L. Treatment of Giant Cell Arteritis (GCA). J Clin Med. 2022 Mar 24;11(7):1799. doi: 10.3390/jcm11071799. PMID: 35407411; PMCID: PMC8999932. Kermani TA, Warrington KJ. Prognosis and monitoring of giant cell arteritis and associated complications. Expert Rev Clin Immunol. 2018 May;14(5):379-388. doi: 10.1080/1744666X.2018.1467758. Epub 2018 Apr 26. PMID: 29676201.
Language eng
Format application/pdf
Type Text
Collection Neuro-Ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-5890
Rights Management Copyright 2023. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s6wzk46r
Setname ehsl_novel_novel
ID 2381840
Reference URL https://collections.lib.utah.edu/ark:/87278/s6wzk46r
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