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Journal of Neurology

, Volume 260, Issue 6, pp 1661–1663 | Cite as

Granulomatosis with polyangiitis masquerading as giant cell arteritis

  • A. McCarthy
  • M. Farrell
  • T. Hedley-Whyte
  • D. McGuone
  • E. Kavanagh
  • S. McNally
  • M. Keogan
  • N. Horgan
  • T. Lynch
  • K. O’Rourke
Letter to the Editors

Dear Sirs,

A 65-year-old man presented with headache, weight loss, occasional scalp tenderness, and visual loss in his left eye, which worsened over a number of weeks to bare light perception. There was a left relative afferent papillary defect with a swollen disc and a small amount of associated hemorrhage. Erythrocyte sedimentation rate (ESR) was 16 mm/1st h, C-reactive protein (CRP) was 3.3 mg/l (normal <7). Temporal artery biopsy demonstrated no evidence of arteritis. On initiation of corticosteroids, his vision improved dramatically and the corticosteroids were subsequently weaned to zero over a period of 6–8 weeks.

Three months later, he re-presented with left-sided ptosis and worsening headache. There had been weight loss (7 kg within the prior 6 months). Examination revealed a complete left-sided ptosis, with normal eye movements. Visual acuity was measured at 6/5−2 on the right and 6/9−2 on the left. Slit-lamp examination was unremarkable.

Laboratory investigations revealed...

Keywords

Mycophenolate Mofetil Giant Cell Arteritis Temporal Artery Biopsy Hypertrophic Pachymeningitis Meningeal Involvement 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest

None.

Ethical standard

The patient gave his informed consent for this publication.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • A. McCarthy
    • 1
  • M. Farrell
    • 2
  • T. Hedley-Whyte
    • 3
  • D. McGuone
    • 3
  • E. Kavanagh
    • 4
  • S. McNally
    • 5
  • M. Keogan
    • 6
  • N. Horgan
    • 7
  • T. Lynch
    • 1
  • K. O’Rourke
    • 1
  1. 1.Dublin Neurological Institute at the Mater Misericordiae University HospitalDublin 7Ireland
  2. 2.Department of NeuropathologyBeaumont HospitalDublinIreland
  3. 3.Charles S. Kubik Laboratory for Neuropathology, Department of PathologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA
  4. 4.Department of RadiologyMater Misericordiae University HospitalDublinIreland
  5. 5.Department of NeurosurgeryBeaumont HospitalDublinIreland
  6. 6.Department of ImmunologyBeaumont HospitalDublinIreland
  7. 7.Royal Victoria Eye and Ear HospitalDublinIreland

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