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A Case Report of Post COVID19 Giant Cell Arteritis and Polymyalgia Rheumatica With Visual Loss

Ali M Mursi1, Hyder O Mirghani2, Adel A Elbeialy3

  • 1Department of Rheumatology-Benha Teaching Hospital, Gothi, Egypt.

Clinical Medicine Insights. Case Reports
|March 28, 2022
PubMed

Insights

Giant-cell arteritis and polymyalgia rheumatica can manifest post-COVID-19, potentially delaying diagnosis and treatment. This case highlights successful management of visual loss and headache using corticosteroids and perineural injection therapy.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Ophthalmology

Background:

  • Giant-cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory conditions requiring prompt diagnosis.
  • COVID-19 shares overlapping symptoms with GCA, potentially complicating diagnosis.
  • Coexistence of COVID-19 and GCA/PMR may lead to diagnostic delays and severe outcomes.

Observation:

  • A patient presented with visual loss and headache following COVID-19 infection.
  • The patient exhibited symptoms suggestive of GCA and PMR.
  • Initial symptoms included persistent headache despite corticosteroid treatment.

Findings:

  • Treatment involved initial pulse methylprednisolone followed by oral prednisolone, aiming for normalization of erythrocyte sedimentation rate (ESR).
  • Adjunctive therapies included paracetamol, vitamin D3, and calcium carbonate.
  • Perineural injection therapy (PIT) was administered for persistent headache, leading to complete resolution.
  • Visual function was fully restored after completing the PIT regimen.

Implications:

  • This case underscores the importance of high clinical suspicion for GCA/PMR in post-COVID-19 patients.
  • Early and comprehensive treatment, including novel approaches like PIT, can reverse severe manifestations such as visual loss.
  • Recognizing the potential for GCA/PMR post-COVID-19 is crucial for timely intervention and improved patient outcomes.

Keywords:
Giant-cell arteritisperineural injectionpolymyalgia rheumaticapost-COVID-19

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