Stewart Crystal, Asif Rana H, Dakkak Tahani, Singh Hardeep, Javaid Muhammad Ali, Patel Nikesh
Graduate Medical Education Research Department, Northeast Georgia Medical Center, Gainesville, Georgia, USA.
Internal Medicine GME Program, Northeast Georgia Medical Center, Gainesville, Georgia 30501, USA.
Case Rep Rheumatol. 2025 Jul 21;2025:6632374. doi: 10.1155/crrh/6632374. eCollection 2025.
Giant cell arteritis (GCA), also known as temporal arteritis, is the most common systemic vasculitis in individuals over 50 and presents diagnostic challenges due to its nonspecific symptoms such as fever, headache, and fatigue. This case report describes the details of a male patient in his 70s who presented with recurrent intermittent fevers of unknown origin and was ultimately diagnosed with GCA after an extensive workup. His initial CT scans and lab tests were unremarkable. However, after a rheumatological workup displayed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels, along with new symptoms of ataxia and headaches, a temporal artery biopsy (TAB) was performed and confirmed the patient had GCA. This case underscores the difficulty in diagnosing GCA primarily due to physician anchoring bias, particularly when typical symptoms are not present. The case also showcases the need for increased awareness and prompt evaluation of potential GCA symptoms to prevent severe complications. Public education as well as improved hospital protocols can lead to earlier detection and treatment of GCA, reducing the risk of morbidity.
巨细胞动脉炎（GCA），也称为颞动脉炎，是50岁以上人群中最常见的系统性血管炎，因其发热、头痛和疲劳等非特异性症状而带来诊断挑战。本病例报告描述了一名70多岁男性患者的详细情况，该患者出现不明原因的反复间歇性发热，经过广泛检查后最终被诊断为GCA。他最初的CT扫描和实验室检查无异常。然而，在进行风湿科检查后，红细胞沉降率（ESR）和C反应蛋白（CRP）水平升高，同时出现共济失调和头痛等新症状，于是进行了颞动脉活检（TAB），证实该患者患有GCA。本病例强调了诊断GCA的困难，主要原因是医生的锚定偏差，尤其是在没有典型症状的情况下。该病例还表明需要提高对潜在GCA症状的认识并及时进行评估，以预防严重并发症。公众教育以及改进医院诊疗方案可导致GCA的早期发现和治疗，降低发病风险。
