Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Department of Ophthalmology, Royal North Shore Hospital, Sydney, New South Wales, Australia.
BMJ Case Rep. 2023 Sep 18;16(9):e255731. doi: 10.1136/bcr-2023-255731.
A man in his 60s presented to the emergency department with marked bilateral preauricular swelling, associated with jaw claudication, temporal tenderness and blurred vision. He was immediately treated for temporal arteritis by commencing systemic corticosteroids. A temporal artery biopsy showed no evidence of vasculitis. However, positron emission tomography-CT demonstrated increased uptake in the medium-large vessels, including the left superficial temporal artery and aorta. This case illustrates that facial swelling may be an under-recognised presenting feature of temporal arteritis, and that a negative temporal artery biopsy does not always rule out a diagnosis of temporal arteritis, and should not delay treatment.
一位 60 多岁的男性因双侧耳前肿胀、下颌跛行、颞部压痛和视力模糊而到急诊科就诊。他立即接受了全身皮质类固醇治疗，以治疗颞动脉炎。颞动脉活检未显示脉管炎的证据。然而，正电子发射断层扫描-CT 显示大中血管摄取增加，包括左侧颞浅动脉和主动脉。本病例说明面部肿胀可能是颞动脉炎的一种未被认识到的表现特征，而且颞动脉活检阴性并不总能排除颞动脉炎的诊断，也不应延误治疗。
