Department of Hematology, Clinical Immunology and Infectious Diseases, Ehime University Graduate School of Medicine, Japan.
Intern Med. 2021 Jul 15;60(14):2333-2336. doi: 10.2169/internalmedicine.6521-20. Epub 2021 Feb 15.
Giant cell arteritis (GCA) is vasculitis of large-sized vessels that can lead to vision loss. We herein report a rare case of GCA accompanied by ptosis and diplopia as early symptoms, which were caused by third nerve palsy. A 78-year-old man presented with fever, right temporal headache, right eyelid ptosis, and diplopia. GCA was confirmed by a temporal artery biopsy. The symptoms disappeared after a slight delay following the administration of prednisolone. Unlike vision loss, ptosis and diplopia are considered to be reversible and responsive to treatment. GCA should not be ruled out if patients exhibit these ophthalmic symptoms.
巨细胞动脉炎(GCA)是一种大血管血管炎,可导致视力丧失。我们在此报告一例罕见的 GCA 病例,其早期症状为动眼神经麻痹引起的上睑下垂和复视。一名 78 岁男性出现发热、右颞部头痛、右眼上睑下垂和复视。经颞动脉活检确诊为 GCA。给予泼尼松龙治疗后稍有延迟,症状消失。与视力丧失不同,上睑下垂和复视被认为是可逆的,并且对治疗有反应。如果患者出现这些眼部症状,不应排除 GCA。