A case of giant cell arteritis with subsequent ischemic stroke: Highlighting treatment challenges | Rawal Medical Journal 2025

Author(s)

Binish Zain Department of Rheumatology, Karachi, Pakistan

Soman Rasool Department of Rheumatology, Karachi, Pakistan

Ashar Ekhlaq Ahmed Department of Rheumatology, Karachi, Pakistan

Mehnaz Mehmood Department of Family Medicine, Dr Ziauddin Hospital,Karachi,Pakistan

Abstract

We present the case of a 74-year-old male with Diabetes Mellitus and angina who was diagnosed with Giant Cell Arteritis (GCA) but received suboptimal treatment with low-dose prednisolone despite persistently elevated erythrocyte sedimentation rate. This led to progressive symptoms, including headache, jaw claudication, and eventual vision loss. Treatment with high-dose IV methylprednisolone initially improved symptoms. However, he developed acute ischemic infarctions in the posterior circulation, followed by complications such as vertigo, bilateral visual loss, and encephalopathy. Des-pite aggressive management with dual antiplatelet the-rapy and corticosteroids, the patient succumbed to com-plications. This case highlights the importance of timely and adequate GCA treatment, especially in patients with comorbidities.

Publication Details

Page(s) 547-549

DOI DOI not available

Published Journal: Rawal Medical Journal, Volume: 50, Issue: 2, Year: 2025

Keywords

Ischemic Stroke Giant cell arteritis largevessel vasculitis cerebrovascular complications

References

Chen JJ,Leavitt JA,Fang C .2016 .Evaluating the incidence of arteritic ischemic optic neuropathy and other causes of vision loss from giant cell arteritis. Ophthalmology, 123 : 1999-2003.

Gonzalez-Gay MA,Vazquez-Rodriguez TR,Gomez-Acebo I .2009 .Strokes at time of disease diagnosis in a series of 287 patients with biopsy-proven giant cell arteritis. Medicine (Baltimore), 88 : 227-35.

Samson M,Jacquin A,Audia S. .2015 .Stroke associated with giant cell arteritis: A population-based study. J Neurol Neurosurg Psychiatry, 86 : 216-21.

de Boysson H,Liozon E,Larivière D. .2017 .Giant cell arteritisrelated stroke: A retrospective multicenter case-control study. J Rheumatol, 44 : 297-303.

Chimowitz MI,Lynn MJ,Derdeyn CP .2011 .Stenting versus aggressive medical therapy for intracranial arterial stenosis. N Engl J Med, 365 : 993-1003.

Chimowitz MI,Lynn MJ,Howlett-Smith H MJ .2005 .Comparison of warfarin and aspirin for symptomatic intracranial arterial stenosis. N Engl J Med, 352 : 1305-16.

Salvarani C .2018 .Giant cell arteritis: A review. JAMA, 320 : 2451-62.

Kermani TA .2015 .Cerebrovascular accidents in giant cell arteritis: A population-based study. Arthritis Care Res (Hoboken), 67 : 361-8.

Benson JC. .2017 .The use of tocilizumab in giant cell arteritis. Rheumatology, 56 : 1710-8.

Cavalli G,Jayne D,Rojas-Rivera J .2019 .Cerebrovascular accidents in giant cell arteritis: A systematic review and metaanalysis. J Neurol Sci, 399 : 1-7.

Citations

Citations are not available for this document.