Temporal Arteritis and Vision Loss in Microscopic Polyangiitis: A Case Report and Literature Review

Area of Science:

• Rheumatology
• Immunology
• Pathology

Background:

• Microscopic polyangiitis (MPA) is a systemic autoimmune vasculitis.
• MPA commonly affects the lungs and kidneys but can involve multiple organ systems.
• Temporal artery involvement is an exceptionally rare manifestation of MPA.

Observation:

• A patient initially presented with symptoms suggestive of giant cell arteritis.
• The patient's temporal artery biopsy findings were atypical.
• Further investigation led to the diagnosis of microscopic polyangiitis.

Findings:

• This case underscores the importance of considering MPA in the differential diagnosis.
• Atypical temporal artery biopsy findings can indicate alternative vasculitic processes.
• Systemic vasculitis requires comprehensive diagnostic consideration beyond typical organ involvement.

Implications:

• Clinicians should consider microscopic polyangiitis in patients with unexplained systemic vasculitis.
• Atypical findings in temporal artery biopsies warrant a broader differential diagnosis.
• Recognizing rare presentations of MPA improves diagnostic accuracy and patient outcomes.