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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Temporal arteritis presenting with gastrointestinal symptoms in a middle aged man
Hasan S Jafri1, Christopher Sofianos, Eyas M Hattab
1Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
Journal of General Internal Medicine
|July 1, 2006
Summary
Giant cell arteritis, or temporal arteritis, can present atypically. This case highlights a young patient with initial gastrointestinal symptoms, later developing classic vision loss and headaches, emphasizing the need for broad differential diagnoses.
Area of Science:
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA), or temporal arteritis, is a large vessel vasculitis of unknown cause.
- It typically affects individuals over 50, presenting with headache, jaw claudication, and visual disturbances.
Observation:
- A 48-year-old male presented with a two-week history of fever, diffuse abdominal pain, and malaise.
- Initial investigations revealed elevated bilirubin and alkaline phosphatase, leading to a cholecystectomy for suspected porcelain gallbladder.
Findings:
- Post-operatively, the patient developed painless, intermittent vision loss and unilateral headaches.
- Temporal artery biopsy confirmed GCA with marked lymphocytic infiltrate, despite the patient's younger age and initial gastrointestinal presentation.
Implications:
- This case underscores that temporal arteritis can occur at a younger age than typically expected.
- Atypical presentations, particularly with prominent gastrointestinal symptoms, necessitate a high index of suspicion for GCA in the differential diagnosis.
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