Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report
Differentiating GCA from its many mimickers remains a challenge in the daily clinical practice, especially in patients presenting with unspecific manifestations. We present the case of an 82-year-old woman who presented with a 3-week history of left eye vision loss secondary to bilateral edema and h...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Karger Publishers
2022-12-01
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| Series: | Case Reports in Neurology |
| Subjects: | |
| Online Access: | https://www.karger.com/Article/FullText/527876 |
| _version_ | 1797975030556000256 |
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| author | Alicia Rodriguez-Pla Marie F. Grill Geoffrey P. Fletcher Marie A. Di Nome |
| author_facet | Alicia Rodriguez-Pla Marie F. Grill Geoffrey P. Fletcher Marie A. Di Nome |
| author_sort | Alicia Rodriguez-Pla |
| collection | DOAJ |
| description | Differentiating GCA from its many mimickers remains a challenge in the daily clinical practice, especially in patients presenting with unspecific manifestations. We present the case of an 82-year-old woman who presented with a 3-week history of left eye vision loss secondary to bilateral edema and hemorrhage of the optic discs. Despite negative bilateral temporal artery biopsies, the elevation of the inflammatory markers and brain MRA findings suggestive of temporal arteritis as well as stenosis of the basilar artery led us to initiate treatment with high-dose steroids. Inflammatory markers remained elevated despite high-dose steroids which prompted additional work leading to a diagnosis of varicella-zoster encephalitis. Steroid treatment was quickly tapered off and treatment with acyclovir resulted in the normalization of the acute phase reactants. The persistence of elevated inflammatory markers despite high-dose steroids should prompt additional work up for the search of an alternative diagnosis of GCA mimickers. |
| first_indexed | 2024-04-11T04:29:09Z |
| format | Article |
| id | doaj.art-424f8f14921741db86066c381e7a18bf |
| institution | Directory Open Access Journal |
| issn | 1662-680X |
| language | English |
| last_indexed | 2024-04-11T04:29:09Z |
| publishDate | 2022-12-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Neurology |
| spelling | doaj.art-424f8f14921741db86066c381e7a18bf2022-12-29T10:32:26ZengKarger PublishersCase Reports in Neurology1662-680X2022-12-0114348349010.1159/000527876527876Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case ReportAlicia Rodriguez-Pla0https://orcid.org/0000-0002-6255-5306Marie F. Grill1Geoffrey P. Fletcher2Marie A. Di Nome3https://orcid.org/0000-0003-1007-8947Division of Rheumatology, University of California San Fracisco (UCSF) in Fresno, Fresno, CA, USAMayo Clinic Arizona, Department of Neurology, Scottsdale, AZ, USAMayo Clinic Arizona, Department of Neuroradiology, Scottsdale, AZ, USAMayo Clinic Arizona, Division of Neuro-ophthalmology, Scottsdale, AZ, USADifferentiating GCA from its many mimickers remains a challenge in the daily clinical practice, especially in patients presenting with unspecific manifestations. We present the case of an 82-year-old woman who presented with a 3-week history of left eye vision loss secondary to bilateral edema and hemorrhage of the optic discs. Despite negative bilateral temporal artery biopsies, the elevation of the inflammatory markers and brain MRA findings suggestive of temporal arteritis as well as stenosis of the basilar artery led us to initiate treatment with high-dose steroids. Inflammatory markers remained elevated despite high-dose steroids which prompted additional work leading to a diagnosis of varicella-zoster encephalitis. Steroid treatment was quickly tapered off and treatment with acyclovir resulted in the normalization of the acute phase reactants. The persistence of elevated inflammatory markers despite high-dose steroids should prompt additional work up for the search of an alternative diagnosis of GCA mimickers.https://www.karger.com/Article/FullText/527876vasculitisgiant cell arteritisischemic optic neuropathyvaricella zoster virusencephalitiscase report |
| spellingShingle | Alicia Rodriguez-Pla Marie F. Grill Geoffrey P. Fletcher Marie A. Di Nome Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report Case Reports in Neurology vasculitis giant cell arteritis ischemic optic neuropathy varicella zoster virus encephalitis case report |
| title | Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report |
| title_full | Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report |
| title_fullStr | Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report |
| title_full_unstemmed | Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report |
| title_short | Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report |
| title_sort | ischemic optic neuropathy secondary to varicella zoster vasculitis mimicking giant cell arteritis case report |
| topic | vasculitis giant cell arteritis ischemic optic neuropathy varicella zoster virus encephalitis case report |
| url | https://www.karger.com/Article/FullText/527876 |
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