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Spinal cord infarction in giant cell arteritis associated with scalp necrosis

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Abstract

Spinal cord infarction is extremely rare in patients with giant cell arteritis (GCA). There are only four case reports in the literature. We describe a 65-year-old man who presented with sudden paraplegia and back pain of 4-days duration with sensory loss below the umbilicus and bilateral scalp necrosis. Magnetic resonance imaging finding was consistent with dorsal spinal cord infarction. Biopsy of the temporal artery confirmed the diagnosis of GCA. The patient was treated with high dose of corticosteroids, which resulted in healing of the scalp ulcerations in 3 weeks, but the paraplegia was irreversible. To our knowledge, this is the first report of spinal cord infarction and simultaneous occurrence of bilateral scalp necrosis in a histopathologically proven GCA. Although literature about spinal cord involvement in GCA is very limited, cord infarction is associated with high mortality and therapeutic challenges since little is understood regarding the pathogenesis that leads to infarction.

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Authors and Affiliations

  1. Rheumatology Unit, Department of Internal Medicine, Jordan University Hospital, The University of Jordan, Queen Rania St, P.O. Box 13046, Amman, 11942, Jordan

    Khader N. Mustafa & Anwar Joudeh

  2. Department of Radiology, Jordan University Hospital, The University of Jordan, Amman, Jordan

    Azmy Hadidy

  3. Department of Pathology and Microbiology and Forensic Medicine, Jordan University Hospital, The University of Jordan, Amman, Jordan

    Fatima Nouri Obeidat & Khalid W. Abdulfattah

Authors
  1. Khader N. Mustafa
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  2. Azmy Hadidy
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  3. Anwar Joudeh
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  4. Fatima Nouri Obeidat
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  5. Khalid W. Abdulfattah
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Correspondence to Khader N. Mustafa.

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Mustafa, K.N., Hadidy, A., Joudeh, A. et al. Spinal cord infarction in giant cell arteritis associated with scalp necrosis. Rheumatol Int 35, 377–381 (2015). https://doi.org/10.1007/s00296-014-3089-9

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  • DOI: https://doi.org/10.1007/s00296-014-3089-9

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