AUG 27, 2012
Normal ESR . . . Could It Still Be Giant Cell Arteritis?
By Jacinthe Rouleau, MD
Subspecialty Day 2011: Neuro-Ophthalmology
Neuro-Ophthalmology/Orbit
In this case discussion from Neuro-Ophthalmology Subspecialty Day 2011, a 78-year-old patient presents with acute vision loss in her left eye. Two days prior to presentation, she complained to her daughter about transient obfuscations and “dim light.” Her weight is stable and she denies jaw claudication and scalp tenderness. Dilated fundus examination of the right eye is normal; the left optic nerve, however, is pale and edematous. Her temporal arteries on both sides are pulsatile and normal in appearance. Because of your suspicion for giant cell arteritis, you order a Westergren erythrocyte sedimentation rate (ESR) test, and it returns at 30 mm/ hour. How would you manage this patient?