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Giant cell arteritis presenting with bilateral orbital inflammatory disease and enhancing superficial temporal arteries
  1. Jamie R Mitchell1,
  2. Iris Krashin-Bichler2,
  3. Marc Rosenblum3,
  4. Eli L Diamond4,
  5. Marc J Dinkin1
  1. 1Department of Ophthalmology, Weill Cornell Medical Center, New York, New York, USA
  2. 2Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel
  3. 3Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  4. 4Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
  1. Correspondence to Dr Jamie R Mitchell, Department of Ophthalmology, Weill Cornell Medical Center, 1305 York Ave. 11th floor, New York, NY 10021, USA; jam9181{at}med.cornell.edu

http://dx.doi.org/10.1136/practneurol-2014-000834

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    Case report

    A 68-year-old man with metastatic prostate cancer was admitted with a 1-week history of bilateral ‘conjunctivitis’, headaches and horizontal diplopia. On examination, the superficial temporal arteries were bilaterally prominent and indurated, with conjunctival injection and chemosis. There were bilateral abduction deficits, but visual acuity and fundi were normal.

    MR scan of the brain and orbits showed bilateral enhancement of the temporal arteries with intraconal fat stranding but with no extra-ocular muscle enlargement or orbital mass (figure 1A,B). His erythrocyte sedimentation rate was elevated at 103 mm/1st h (<20), serum C reactive protein was 14 mg/L (<10) and CSF: …

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    Footnotes

    • Contributors JRM was the corresponding author and contributed to the manuscript content, editing and submission. IKB and ELD contributed to the manuscript content and editing. MR contributed the pathology images and descriptions. MJD contributed to editing and content of the manuscript.

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed. This paper was reviewed by Ashwin Pinto, Southampton, UK.

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