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Case report
Normal inflammatory markers in giant cell arteritis with long-standing cranial and symptomatic large-vessel involvement
  1. Alicia Rodriguez-Pla1,
  2. Sailendra G Naidu2,
  3. Yasmeen M Butt3 and
  4. Victor J Davila4
  1. 1Division of Rheumatology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
  2. 2Division of Interventional Radiology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
  3. 3Division of Anatomic Pathology, Mayo Clinic Arizona, Scottsdale, Arizona, USA
  4. 4Division of Vascular Surgery, Mayo Clinic Arizona, Scottsdale, Arizona, USA
  1. Correspondence to Dr Alicia Rodriguez-Pla; rodriguezpla.alicia{at}mayo.edu

Abstract

We report the case of a 78-year-old woman who presented with cardiovascular risk factors and a history of an atypical transient ischaemic attack. She was referred by her primary care physician to the vascular surgery department at our institution for evaluation of progressive weakness, fatigue, arm claudication and difficulty assessing the blood pressure in her right arm. She was being considered for surgical revascularisation, but a careful history and review of her imaging studies raised suspicion for vasculitis, despite her normal inflammatory markers. She was eventually diagnosed with biopsy-proven giant cell arteritis with diffuse large-vessel involvement. Her symptoms improved with high-dose glucocorticoids.

  • vasculitis
  • connective tissue disease
  • musculoskeletal syndromes

https://doi.org/10.1136/bcr-2021-242602

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    Footnotes

    • Twitter @AliciaRPla

    • Contributors AR-P, SGN, YB and VJD: Substantial contributions to the conception or design of the work; or the acquisition, analysis or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • 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.

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