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[Amaurosis fugax with elevated acute phase proteins].
C Tappeiner1, S Wolf, P Trittibach
1Klinik und Poliklinik für Augenheilkunde, Inselspital, Universität Bern.
Praxis
|November 9, 2007
Summary
Giant cell arteritis can cause temporary vision loss (amaurosis fugax) and headaches, even with normal erythrocyte sedimentation rate (ESR). Elevated acute-phase proteins, like C-reactive protein, aid diagnosis in such cases.
Area of Science:
- Ophthalmology
- Rheumatology
- Neurology
Background:
- Giant cell arteritis (GCA) is a vasculitis affecting large arteries, often presenting with headache and visual disturbances.
- Amaurosis fugax, a transient monocular vision loss, can be a symptom of GCA.
Observation:
- A 66-year-old woman experienced recurrent amaurosis fugax and hemicranial headaches.
- Ophthalmologic and neurological examinations, along with imaging, were normal.
- Erythrocyte sedimentation rate (ESR) was within the normal range for her age.
Findings:
- Acute-phase proteins, specifically C-reactive protein and fibrinogen, were elevated.
- Temporal artery biopsy confirmed the diagnosis of giant cell arteritis.
Implications:
- Giant cell arteritis should be considered in the differential diagnosis of amaurosis fugax, irrespective of normal ESR.
- Elevated acute-phase protein levels can provide crucial diagnostic information in suspected GCA cases.
- This case highlights the importance of comprehensive inflammatory marker assessment beyond ESR for diagnosing GCA.
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