Two cases of recurrent stroke in treated giant cell arteritis: diagnostic and therapeutic dilemmas

Alasdair J Fitzgerald, James W Ironside, David M Summers, Martin S Dennis, Euan R McRorie

Research output: Contribution to journalArticlepeer-review

Abstract

It is not established whether the increased risk of stroke in patients with giant cell arteritis (GCA) is because of atherosclerosis, persistent arterial inflammation, or an iatrogenic effect of corticosteroids. This creates difficulties in choosing the most appropriate treatment. We report 2 patients with GCA who developed repeated strokes involving different arterial territories following initiation of corticosteroid therapy, despite resolution of cranial symptoms and normalization of inflammatory markers. Subsequent investigation suggested persisting arteritis as the cause of these strokes. The cases revealed the limitations of laboratory tests or imaging techniques in determining the cause of stroke in recently diagnosed GCA. There is a need to develop effective means of monitoring GCA activity and to determine the most effective treatment approach in this circumstance.
Original languageEnglish
Pages (from-to)225-8
Number of pages4
JournalJCR: Journal of Clinical Rheumatology
Volume16
Issue number5
DOIs
Publication statusPublished - Aug 2010

Keywords

  • Adrenal Cortex Hormones
  • Aged, 80 and over
  • Biopsy
  • Female
  • Giant Cell Arteritis
  • Humans
  • Male
  • Middle Aged
  • Prednisolone
  • Recurrence
  • Risk Factors
  • Stroke
  • Temporal Arteries

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