Delayed diagnosis of biopsy-negative giant cell arteritis presenting as fever of unknown origin

Valentin S. Schäfer, Kenneth J Warrington, Eric E. Williamson, Tanaz A. Kermani

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Fever of unknown origin (FUO) presents a diagnostic challenge. Giant cell arteritis (GCA) may present with FUO and this entity should be included in the differential of elderly patients who present with constitutional symptoms. While a temporal artery biopsy is considered the gold standard for the diagnosis of GCA, a subset of patients with large vessel involvement by GCA may have a negative temporal artery biopsy and no cranial symptoms. We present a 79 year-old woman with FUO and negative temporal artery biopsies in whom diagnosis of GCA was delayed. Further imaging with CT-angiogram and positron emission tomography/computed tomography (PET/CT) scan showed diffuse extensive active vasculitis. The above case underscores the value of imaging studies in the evaluation of patients with FUO from occult large vessel vasculitis.

Original languageEnglish (US)
Pages (from-to)532-536
Number of pages5
JournalJournal of General Internal Medicine
Volume24
Issue number4
DOIs
StatePublished - Apr 2009

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Fever of Unknown Origin
Giant Cell Arteritis
Delayed Diagnosis
Temporal Arteries
Biopsy
Vasculitis
Angiography

Keywords

  • Fever of unknown origin
  • Giant cell arteritis
  • Large vessel vasculitis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Delayed diagnosis of biopsy-negative giant cell arteritis presenting as fever of unknown origin. / Schäfer, Valentin S.; Warrington, Kenneth J; Williamson, Eric E.; Kermani, Tanaz A.

In: Journal of General Internal Medicine, Vol. 24, No. 4, 04.2009, p. 532-536.

Research output: Contribution to journalArticle

Schäfer, Valentin S. ; Warrington, Kenneth J ; Williamson, Eric E. ; Kermani, Tanaz A. / Delayed diagnosis of biopsy-negative giant cell arteritis presenting as fever of unknown origin. In: Journal of General Internal Medicine. 2009 ; Vol. 24, No. 4. pp. 532-536.
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