Arterial-embolic Strokes and Painless Vision Loss Due to Phase II Aortitis and Giant Cell Arteritis: A Case Report

Introduction: Aortitis refers to abnormal inflammation of the aorta, most commonly caused by giant cell arteritis (GCA). Herein, we present a 57-year-old female with aortitis and arterial-embolic strokes secondary to GCA. Case Report: Our patient presented to the emergency department following an episode of transient, monocular, painless vision loss. Computed tomography angiogram head and neck demonstrated phase II aortitis, and magnetic resonance imaging revealed evidence of arterial-embolic strokes. Conclusion: Cerebrovascular accident is a rare complication of large-vessel vasculitis and can occur due to multiple underlying etiologies including intracranial vasculitis, aortic branch proximal occlusion, or arterial-embolic stroke.

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Magnetic resonance imaging in the diagnosis and follow-up of giant cell arteritis: case report and review of literature

European Journal of Rheumatology ◽

10.5152/eurjrheum.2015.0080 ◽

2015 ◽

Vol 2 (3) ◽

pp. 125-128 ◽

Cited By ~ 2

Author(s):

Ana Gudelj Gračanin ◽

Josip Ćurić ◽

Jelena Lončarević ◽

Jadranka Morović- Vergles

Keyword(s):

Magnetic Resonance Imaging ◽

Case Report ◽

Magnetic Resonance ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Review Of Literature ◽

Resonance Imaging

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Delayed Diagnosis of Giant Cell Arteritis in the Setting of Isolated Lingual Necrosis

Clinical Medicine Insights Case Reports ◽

10.1177/1179547619857690 ◽

2019 ◽

Vol 12 ◽

pp. 117954761985769

Author(s):

Logan Christopher DeBord ◽

Ilene Chiu ◽

Nelson Eddie Liou

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Rare Complication ◽

Delayed Diagnosis ◽

Temporal Artery ◽

High Dose ◽

Temporal Artery Biopsy ◽

Delay In Diagnosis ◽

Computed Tomography Angiogram ◽

Intravenous Steroids

Background: Lingual necrosis is a rare complication of giant cell arteritis (GCA). Methods: A 77-year-old woman presented for treatment of a painful and discolored tongue, odynophagia, and dehydration refractory to antimicrobials over 2 weeks. An extensive, well-demarcated necrotic area was visualized on the anterior tongue upon admission. Leukocytosis, thrombocytosis, and elevated erythrocyte sedimentation rate were present. Computed tomography angiogram of the head and neck revealed an undulated-beaded appearance of the distal internal carotid arteries and vertebral arteries bilaterally. Results: High-dose intravenous steroids were initiated for suspected vasculitis. Temporal artery biopsy confirmed the diagnosis of GCA. The patient’s condition improved and the anterior tongue was well healed at 1 month follow-up. Conclusions: An atypical presentation of GCA (eg, isolated lingual necrosis) risks a delay in diagnosis and increased morbidity. Any patient above the age of 50 years presenting with tongue necrosis, in the absence of known cause, should undergo expedited workup for GCA.

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Cytomegalovirus Retinal Necrosis With Occlusive Vasculopathy Secondary to Steroid Immunosuppression for Giant Cell Arteritis

Journal of VitreoRetinal Diseases ◽

10.1177/2474126420908717 ◽

2020 ◽

Vol 4 (3) ◽

pp. 227-232

Author(s):

Anne Zeng ◽

Ron Strauss ◽

Sarah E. Goglin ◽

John Gonzales ◽

Varun K. Pawar ◽

...

Keyword(s):

Case Report ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Vision Loss ◽

Oral Prednisone ◽

Central Retinal Artery Occlusion ◽

Retinal Artery Occlusion ◽

Artery Occlusion ◽

Ischemic Optic Neuropathy ◽

The Right

Purpose: This case report discusses an atypical case of cytomegalovirus (CMV) retinal necrosis with panretinal occlusive vasculopathy in a 77-year-old man who was immunosuppressed following treatment for giant cell arteritis (GCA). Methods: A case report is presented. Results: Clinical examination demonstrated a central retinal artery occlusion and pale disc suspicious for arteritic ischemic optic neuropathy in the right eye. Biopsy-proven GCA prompted treatment with oral prednisone. While on glucocorticoid immunosuppression, the patient suffered vision loss in the left eye from CMV-necrotizing retinitis with occlusive vasculopathy. Treatment controlled the CMV infection but tapering of his steroids resulted in worsening GCA, requiring a steroid-sparing treatment, tocilizumab. Conclusions: Corticosteroid immunosuppression for GCA may lead to immune dysfunction allowing for an atypical occlusive vasculitis with retinal necrosis from CMV. Early identification and treatment are essential to adjust the level of immunosuppression and consider alternate therapies to control the GCA and prevent worsening of this opportunistic infection.

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Giant Cell Arteritis in Ophthalmology Practice: a Case Report

Ophthalmology in Russia ◽

10.18008/1816-5095-2019-1-109-114 ◽

2019 ◽

Vol 16 (1) ◽

pp. 109-114

Author(s):

V. A. Chernukha ◽

D. S. Atarschikov ◽

N. V. Khamnagdaeva ◽

I. V. Pozharov

Keyword(s):

Case Report ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Vision Loss ◽

Systemic Vasculitis ◽

Ischemic Optic Neuropathy ◽

Reactive Protein ◽

Retinal Artery ◽

The Right

Introduction. Giant cell (temporal) arteritis refers to a group of chronic and acute systemic vasculitis mainly affecting the extracranial and intracranial arteries of large and medium caliber. Loss of vision due to anterior ischemic optic neuropathy (AION) or occlusion of the central retinal artery is one of the most severe and most common complications of giant cell arteritis. This case report describes a patient with giant cell arteritis, the outcome of it was a total vision loss in the right eye. The patient repeatedly visited the ophthalmologists in the outpatient clinics with complaints of intermittent episodes of vision loss.Purpose. To present methods of diagnosis and treatment, through which the doctor at the initial reception will be able to suspect the disease and start treatment timely.Conclusions. The anamnestic criteria for the GCA diagnosis in the practice of ophthalmologist are: female, age over 50 years, headaches with paresthesia, intermittent lameness of the mandible, short-term episodes of vision loss. The necessary laboratory methods of research include: clinical blood test with determination of erythrocyte sedimentation rate, determination of C-reactive protein level.

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