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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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Cul de Sac : An Unusual Presentation of Giant Cell Arteritis

Chinenye Osuorji1, Naomi Ojumah2, Oluwafeyi Adedoyin3

  • 1Internal Medicine, Burrell College of Osteopathic Medicine, Las Cruces, USA.

Cureus
|August 16, 2021
PubMed

Insights

Giant cell arteritis (GCA), or temporal arteritis, can present atypically. This case highlights scrotal swelling and arm pain as unusual GCA symptoms, emphasizing the need for high clinical suspicion.

Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Internal Medicine

Background:

  • Giant cell arteritis (GCA), also known as temporal arteritis, is a vasculitis primarily affecting large arteries.
  • GCA diagnosis can be challenging due to its diverse and sometimes subtle clinical presentations.
  • Prompt diagnosis and treatment are crucial to prevent severe complications.

Observation:

  • A 69-year-old male presented with painful scrotal swelling and bilateral arm pain.
  • These symptoms were atypical for the common presentations of GCA.
  • Initial diagnostic considerations were broad due to the unusual symptomology.

Findings:

  • Histological examination confirmed Giant Cell Arteritis as the underlying diagnosis.
  • The patient's symptoms resolved completely following high-dose corticosteroid therapy.
  • This case underscores that GCA manifestations can be extracranial and non-specific.

Implications:

  • Clinicians should maintain a high index of suspicion for GCA even with unusual or extracranial symptoms.
  • Atypical presentations of GCA necessitate thorough diagnostic evaluation to avoid treatment delays.
  • Early recognition and management of GCA are vital for preventing irreversible ischemic damage and improving patient outcomes.

Keywords:
autoimmueclinical diagnosisgiant cell arteritisglucocorticoidslarge vessel vasculitispolymyalgia rheumaticatemporal artery biopsy

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