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Related Experiment Videos

Temporal arteritis with normal erythrocyte sedimentation rate.

T G Ganiats1

  • 1Department of Community and Family Medicine, UC San Diego School of Medicine, La Jolla, California 92093-0807.

The Journal of the American Board of Family Practice
|March 1, 1991
PubMed
Summary
This summary is machine-generated.

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Temporal arteritis, a cause of headache in the elderly, can present with a normal erythrocyte sedimentation rate (ESR). This case highlights the importance of considering temporal arteritis even with normal ESR results, especially in patients with high hematocrit.

Area of Science:

  • Geriatric Medicine
  • Rheumatology
  • Clinical Diagnostics

Background:

  • The erythrocyte sedimentation rate (ESR) is a common biomarker used to aid in the diagnosis of various inflammatory conditions.
  • Temporal arteritis (Giant Cell Arteritis) is a critical diagnosis in elderly patients presenting with headaches, as delayed treatment can lead to irreversible vision loss.

Observation:

  • A 74-year-old woman with biopsy-proven temporal arteritis presented with an erythrocyte sedimentation rate (ESR) of 22 mm/hr, which falls within the normal range.
  • The patient's hematocrit was recorded at over 40 percent, a factor previously associated with normal ESR values in temporal arteritis cases.

Findings:

  • This case underscores that temporal arteritis can manifest with a normal ESR, a possibility often underestimated in primary care settings.

Related Experiment Videos

  • Elevated hematocrit may be a confounding factor in interpreting ESR results for temporal arteritis diagnosis.

    • Implications:

    • Clinicians should maintain a high index of suspicion for temporal arteritis in elderly patients with headaches, regardless of ESR levels.
    • Further consideration of clinical presentation and other laboratory markers, such as hematocrit, is crucial when ESR is inconclusive for diagnosing temporal arteritis.