Giant Cell Arteritis Presenting with Mania, Psychosis, and Cognitive Dysfunction: A Case Report
Heidi Madeleine Latvala1,2, Solveig Klæbo Reitan3,4, Arne Einar Vaaler4,5
1Department of Addiction, Division of Mental Health and Addiction, University Hospital of Northern Norway, Åsgårdvegen 40, 9016 Tromsø, Norway.
Case Reports in Psychiatry
|February 23, 2023
Summary
Giant cell arteritis (GCA), an autoimmune vasculitis, can present with unusual psychiatric symptoms like mania. Early diagnosis and treatment are crucial for managing GCA and its diverse manifestations.
Area of Science:
- Rheumatology
- Neurology
- Psychiatry
Background:
- Giant cell arteritis (GCA) is a systemic autoimmune vasculitis targeting medium-to-large arteries.
- Classical GCA symptoms include headache, fever, and jaw claudication, but atypical presentations are increasingly recognized.
- Vascular inflammation in GCA can lead to lumen narrowing, occlusion, vision loss, and stroke.
Observation:
- A 70-year-old woman presented with fluctuating manic symptoms, confusion, headache, and musculoskeletal pain.
- Initial corticosteroid treatment for suspected GCA temporarily worsened manic symptoms.
- Manic symptoms improved after 3-4 weeks of continuous corticosteroid therapy, suggesting a link to GCA.
Findings:
- This case highlights an unprecedented presentation of GCA with prominent psychiatric manifestations.
- The patient's clinical course, including initial manic exacerbation with corticosteroids, is unique.
- GCA was diagnosed based on clinical presentation and response to treatment.
Implications:
- Giant cell arteritis may be underdiagnosed in elderly psychiatric patients.
- Consider GCA in the differential diagnosis of new-onset atypical psychiatric disorders in older adults.
- Raising awareness of GCA's diverse presentations can improve patient outcomes.
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