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Systemic amyloidosis with temporal artery involvement mimicking temporal arteritis
E B Ing1, I Z Woolf, B R Younge
1Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA.
Ophthalmic Surgery and Lasers
|April 1, 1997
Summary
Systemic amyloidosis can mimic temporal arteritis in older men. Negative temporal artery biopsy results prompted further investigation, revealing amyloidosis secondary to multiple myeloma.
Area of Science:
- Internal Medicine
- Rheumatology
- Hematology
Background:
- Giant cell arteritis (GCA), or temporal arteritis, is a common vasculitis in older adults.
- Clinical presentation of GCA includes jaw claudication, arthralgias, myalgias, weight loss, and fatigue.
- Temporal artery biopsy is the gold standard for diagnosing GCA.
Observation:
- A 77-year-old man presented with symptoms suggestive of temporal arteritis.
- Temporal artery biopsy showed no evidence of vasculitis.
- Amyloidosis was suspected and confirmed via Congo red staining.
Findings:
- Bone marrow biopsy revealed multiple myeloma.
- The patient was diagnosed with systemic amyloidosis secondary to multiple myeloma.
- The initial presentation was misleading, mimicking temporal arteritis.
Implications:
- Systemic amyloidosis should be considered in the differential diagnosis of patients presenting with symptoms suggestive of temporal arteritis, especially when temporal artery biopsy is negative for vasculitis.
- This case highlights the importance of considering alternative diagnoses when initial investigations do not align with suspected conditions.
- Early and accurate diagnosis of systemic amyloidosis is crucial for appropriate management and improved patient outcomes.