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Case ReportOpen Access
A Variety of Atypical Manifestations in Giant Cell Arteritis
Aui-aree N 
,
Tungsinmunkong K ,
Hirunpat S ,
Ratanasukon M ,
Wangsupadilok B
,
Tungsinmunkong K ,
Hirunpat S ,
Ratanasukon M ,
Wangsupadilok B Giant cell arteritis (GCA) is a chronic granulomatous vasculitis of large and medium size vessels in the elderly. A
new-onset headache is the most frequent symptom. An anterior ischemic optic neuropathy (AION) is one of the most common
causes of permanent visual loss. There are four cases with unusual presentation of giant cell arteritis, scalp abscess,
prolonged transient monocular visual loss (TMVL), bilateral central retinal artery occlusion (CRAO), and chronic ear pain.
All patients had pathologically proven giant cell arteritis, and three of them progressed to blindness in the end. Scalp abscess
is a rare sign in GCA. Delay in diagnosis because confusion of the abscess after scalp ischemia with other cutaneous lesions
may result in death. TMVL is the forewarning symptom of AION or CRAO in GCA. Early recognition of TMVL is important
to make early diagnosis of GCA to prevent blindness. Spontaneous ear pain is extremely rare, and reports have documented
delay in diagnosis of GCA resulting in irreversible blindness.
Keywords: Bilateral central retinal artery occlusion, Chronic ear pain, Giant cell arteritis, Scalp abscess, Temporal arteritis
new-onset headache is the most frequent symptom. An anterior ischemic optic neuropathy (AION) is one of the most common
causes of permanent visual loss. There are four cases with unusual presentation of giant cell arteritis, scalp abscess,
prolonged transient monocular visual loss (TMVL), bilateral central retinal artery occlusion (CRAO), and chronic ear pain.
All patients had pathologically proven giant cell arteritis, and three of them progressed to blindness in the end. Scalp abscess
is a rare sign in GCA. Delay in diagnosis because confusion of the abscess after scalp ischemia with other cutaneous lesions
may result in death. TMVL is the forewarning symptom of AION or CRAO in GCA. Early recognition of TMVL is important
to make early diagnosis of GCA to prevent blindness. Spontaneous ear pain is extremely rare, and reports have documented
delay in diagnosis of GCA resulting in irreversible blindness.
Keywords: Bilateral central retinal artery occlusion, Chronic ear pain, Giant cell arteritis, Scalp abscess, Temporal arteritis
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