You Never Think Enough About Giant Cell Arteritis.

PURPOSE: Diagnosis of giant cell arteritis (GCA) can sometimes be challenging, especially in the setting of a negative CRP.

METHODS

We report a challenging case of GCA.

RESULTS

A 73-year-old male patient presented with unilateral paracentral acute middle maculopathy (PAMM). Because the patient demonstrated homolateral internal carotid artery stenosis, and two negative CRP tests, the diagnosis of GCA could have been overlooked if diffuse aortitis had not been observed on supraortic CT-scan. The diagnosis was further confirmed with PET scan, demonstrating femoral arteritis in addition to aortitis.

CONCLUSION

If PAMM and negative CRP are frequently encountered in "cranial GCA," "aortoarteritic GCA" is usually associated with inflammatory signs, which was not the case in this patient, reminding us that a high degree of suspicion should always be maintained in case of PAMM in elderly patients.