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An unusual case of “giant cell arteritis”
  1. J Lim,
  2. R Ramachandran,
  3. R Madhok,
  4. H Capell
  1. Centre of Rheumatic Diseases, Glasgow Royal Infirmary, Glasgow, Scotland, UK
  1. Correspondence to:
    Dr R Madhok
    Centre of Rheumatic Diseases, Ward 14/15, Glasgow Royal Infirmary, Castle Street, Glasgow G4 0SF, Scotland, UK; gcl103clinmed.gla.ac.uk

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Cholesterol emboli syndrome (CES) can be confused with a small vessel vasculitis but it is unusual for it to be mistaken for giant cell arteritis. We report a patient with temporal headaches, transient visual loss, and raised inflammatory indices, which led to an initial diagnosis of giant cell arteritis, but in whom CES was the eventual explanation.

CASE REPORT

A 64 year old woman with treated hypertension who smoked was referred with a 1 year history of left sided temporal headaches and pain in the proximal lower limbs. The headaches were intermittent but were increasing in frequency and intensity. She also described two episodes of blurred vision of short duration in the left eye. There were no other associated neurological symptoms. She gave a history of Raynaud’s phenomenon in both hands and worsening activities of daily living limited by fatigue.

She was overweight with a body mass index of 27 kg/m2; there …

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