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Abstract #5765 Published in IGR 2-1
Giant cell arteritis, bilateral anterior ischemic optic neuropathy and anticardiolipin antibodies
Ezpeleta D; Rodriguez-Mahou M; Munoz-Blanco JLRevista de Neurologia 1999; 29:1185-1187
CLINICAL CASE: The authors report a case of giant cell arteritis (GCA) that developed acute bilateral amaurosis secondary to anterior ischemic optic neuropathy (AION), with no other symptoms and with a normal erythrocyte sedimentation rate (ESR). Physical examination revealed painless and pulseless temporal arteries, ophthalmoscopic findings were blurring of margins, hyperemia and elevation of both optic discs. Visual acuity was limited to hand motion perception and light-darkness discrimination. Six months before of this syndrome, the patient was diagnosed of polymyalgia rheumatica and was maintained asymptomatic with 6 mg/day of deflazacort. Temporal artery biopsy provided diagnosis. An elevated IgG type anticardiolipin antibody (ACA) rate was detected in serum. The remaining laboratory studies were normal. CONCLUSIONS: In old people with uni- or bilateral acute visual loss, even with normal erythrocyte sedimentation rate and without other symptoms associated, a high index of suspicion is needed in order to detect giant cell arteritis. This can facilitate early diagnosis and immediate initiation of treatment with high doses of corticosteroids. An elevated level of IgG type anticardiolipin antibodies may be a risk factor to thrombotic complications, such as anterior ischemic optic neuropathy, in patients with giant cell arteritis. LA: Spanish
Dr. D. Ezpeleta, Servicio de Neurologia, Hospital Mutua de Terrassa, Barcelona, Spain dezpeleta@cvneuro.org
Classification:
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy
