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Temporal arteritis presenting with jaw claudication and normal erythrocyte sedimentation rate
Sudden vision loss in elderly patients with jaw claudication may signal a serious condition. Prompt diagnosis and steroid treatment are crucial to prevent permanent blindness.
Area of Science:
- Ophthalmology
- Rheumatology
- Geriatrics
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries, primarily in older adults.
- Ocular involvement in GCA can lead to irreversible vision loss if not treated promptly.
- Jaw claudication is a key, though sometimes isolated, symptom suggestive of GCA.
Observation:
- An 81-year-old woman presented with sudden right eye blindness.
- She had a one-month history of progressively worsening jaw claudication.
- Her Westergren sedimentation rate was normal, a common finding in some GCA cases.
Findings:
- The case highlights isolated jaw claudication as a critical diagnostic clue in the elderly.
- Normal inflammatory markers do not exclude the diagnosis of GCA.
- Temporal artery biopsy is essential for confirming GCA.
Implications:
- Early diagnosis of GCA through symptom recognition and biopsy is vital.
- Immediate high-dose corticosteroid therapy is necessary to prevent vision loss.
- This case underscores the importance of considering GCA in elderly patients with isolated jaw claudication and visual symptoms.
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