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Case report
Boundaries of a systemic disease: a protean presentation of giant cell arteritis
  1. António Mesquita1,2,
  2. Lara Camara1,
  3. Catarina Patrício1 and
  4. Vítor Brotas1
  1. 1Internal Medicine, Hospital Santo António dos Capuchos, Lisboa, Portugal
  2. 2Pathophysiology Department, NOVA Medical School, Lisboa, Portugal
  1. Correspondence to Dr António Mesquita; aefpmesquita{at}


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.

  • vasculitis
  • connective tissue disease

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  • Contributors AM and LC have contributed to the redaction of the article. CP and VB were responsible for reviewing the main document and advising on the writting process.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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