Prevalence of a Normal C-Reactive Protein with an Elevated Erythrocyte Sedimentation Rate in Biopsy-Proven Giant Cell Arteritis

Clinical Findings and Management of Giant Cell Arteritis

“…NAION tends to be strongly associated with high cholesterol, smoking, hypertension, diabetes, and heart disease (in decreasing order of associated risk). This condition tends to present as painless vision loss and most often is unilateral with a sudden onset [13,15].…”

“…The newest laboratory test being investigated is the anti-cardiolipin antibody test, which is elevated in giant cell, but is not elevated in other types of systemic inflammation (a disadvantage for both the ESR and CRP). The disadvantage with this particular test is that it is expensive for the patient and there is no normative data published on it [14][15][16].…”

“…Giant cell arteritis tends to present with worse visual acuity compared to non-arteritic ischemic optic neuropathy. Also, GCA tends to have ischemic lesions somewhere in the retina, including central retinal artery occlusions, cilioretinal artery occlusions, or cotton-wool spots [15][16]26]. Additionally, patients with giant cell tend to report amaurosis fugax, and may be the only symptom that the patient reports [1][2][3][4][5][6][7][8][10][11][12][13][20][21][22][23][24][25][26].…”

“…Specific visual symptoms that clinicians need to be aware of are transient or permanent visual distortion or loss of vision in one or both eyes, double vision, occasionally hallucinations, and ocular pain [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Permanent vision loss tends to result in patients diagnosed with GCA, especially if it is left untreated; this vision loss can be unilateral or bilateral depending on when treatment is initiated.…”

“…If GCA is suspected in a patient, same day erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) blood tests should be performed and high dose corticosteroids should be prescribed for the patient, even before a temporal artery biopsy is performed. The idea behind the high dose corticosteroids is to reduce the systemic inflammation and essentially "protect" the eye that still has vision remaining [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][18][19][20][21][22]. elicited in office when the area was palpated.…”