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AB0088 Pulse cyclophosphamide therapy in a patient of giant cell arteritis with diplopia due to unilateral abducens nerve palsy
  1. JC Tseng,
  2. HH Cheng,
  3. RJ Hu,
  4. LY Lu
  1. Allergy, Immunology and Rheumatology, Veterans General Hospital, Kaohsiung, Taiwan, R.O.C

Abstract

Background Patients with giant cell arteritis (GCA) occasionally complain of double vision. The neurologic manifestations of the GCA are protean. All parts of the visual pathway from the cornea to the cortex have been described to be involved.

Objectives We described a patient of GCA with diplopia due to left abducens nerve palsy which was refractory to corticosteroid therapy initially and recovered with monthly pulse cyclophosphamide therapy five months later. To the best of our knowledge this is the first case described in the medical literature to be treated with monthly pulse intravenous cyclophosphamide and to achieve a successful outcome.

Conclusion Giant cell arteritis should be considered in the differential diagnois of patients with ocular manifestations. Prompt diagnosis and treatment are reguired if second eye involvement and blindness are to be prevented.

References

  1. Lee AG. Ocular manifestations of giant cell arteritis. Am J Ophthalmol. 1998;126(5):742–4

  2. Glutz von BS, Borruat FX. Neuro-ophthalmic complications of biopsy-proved giant cell arteritis. Eur J Ophthalmol. 1997;7(4):375–82

  3. Johnston JL, Thomson GT, Sharpe JA, Inman RD. Internuclear ophthalmoplegia in giant cell arteritis. J Neurol Neurosurg Psychiatry 1992;55(1):84–5

  4. Goadsby PJ, Mossman S. Giant cell arteritis and ophthalmoplegia. Aust NZ J Med. 1991;21(6):930

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