A Case of Giant Cell Arteritis in Which Color Duplex Ultrasonography was Useful for Making the Diagnosis

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  • NAKAMURA Yuka
    Division of Dermatology, Yamaguchi University Graduate School of Medicine
  • NEMOTO Kei
    Division of Dermatology, Yamaguchi University Graduate School of Medicine
  • YAMAGUCHI Michiya
    Division of Dermatology, Yamaguchi University Graduate School of Medicine
  • ICHIMIYA Makoto
    Division of Dermatology, Yamaguchi University Graduate School of Medicine
  • MUTO Masahiko
    Division of Dermatology, Yamaguchi University Graduate School of Medicine

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Other Title
  • カラードプラ超音波検査が有用であった側頭動脈炎の 1 例
  • 症例 カラードプラ超音波検査が有用であった側頭動脈炎の1例
  • ショウレイ カラードプラ チョウオンパ ケンサ ガ ユウヨウ デ アッタ ソクトウ ドウミャクエン ノ 1レイ

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Abstract

A 75-year-old Japanese man, who had been suffering from headaches for 4 months, noticed within the last month tenderness and swelling with subcutaneous induration of bilateral temporal areas, along with jaw claudication when opening his mouth. On blood tests, the C-reactive protein (CRP) level was 9.30 mg/dl, the ESR was 87 mm/h, and IL-6 was 20.0 pg/ml. Color duplex ultrasonography showed a hypoechoic halo sign around the inflamed temporal arteries. On histopathological examination of a right superficial temporal artery biopsy specimen, granulomatous inflammation with multinucleated giant cells was seen, with disruption of the internal elastic lamina on Elastica van Gieson staining. He was diagnosed as having giant cell arteritis (GCA) and treated with oral prednisolone 40 mg/day. His clinical symptoms improved markedly, and the CRP and ESR levels were normalized within 10 days. Patients with GCA respond well to steroid treatment, and their life prognosis is comparatively good. However, in some cases with eye involvement complete visual loss can occur, if the condition is not treated. Thus, a rapid diagnosis and early therapy are needed. We suggest that color duplex ultrasonography is a useful, non-invasive method for the early diagnosis of GCA.

Journal

  • Nishi Nihon Hifuka

    Nishi Nihon Hifuka 75 (3), 200-203, 2013

    Western Division of Japanese Dermatological Association

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