Atypical presentation of giant cell arteritis associated with SIADH: a rare association

BMJ Case Rep. 2021 Dec 31;14(12):e246187. doi: 10.1136/bcr-2021-246187.

Abstract

We present here an interesting case of a 67-year-old man with 3 weeks history of lethargy, loss of appetite, generalised weakness and weight loss. Following thorough investigations, occult malignancy was ruled out. Hyponatraemia was a consistent finding which needed further classification. Additional workup including cerebral imaging and neurophysiological studies excluded cerebral vascular events and myopathies. Vasculitis screening was undertaken, and the diagnostic dilemma was revealed by the temporal arteries Doppler ultrasound which showed classical 'halo sign'. Diagnosis of temporal arteritis was made and linked with syndrome of inappropriate antidiuretic hormone secretion, which appears to be a rare association with few instances on record. Patient was treated with high dose of prednisolone with marked improvement of clinical features.

Keywords: endocrine system; musculoskeletal and joint disorders; musculoskeletal syndromes.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Giant Cell Arteritis* / complications
  • Giant Cell Arteritis* / diagnosis
  • Giant Cell Arteritis* / drug therapy
  • Humans
  • Inappropriate ADH Syndrome* / complications
  • Inappropriate ADH Syndrome* / diagnosis
  • Male
  • Prednisolone / therapeutic use
  • Temporal Arteries / diagnostic imaging
  • Ultrasonography

Substances

  • Prednisolone