Atypical presentation of giant cell arteritis: a case report

A 58-year-old female, known hypertensive and hypothyroid, presented with complaints of diffuse headache, decreased appetite, and easy fatiguability over 2 months. Laboratory tests revealed elevated acute phase reactants (ESR-140 mm/1st hour, CRP-70 mg/l), positive ANA profile with anti-Pm-SCL 100 and AMA-M2 positivity. During subsequent visits, she had a recurrence of headaches along with dyspnea on exertion (DOE) being her predominant symptom limiting her daily activities. A superficial temporal artery doppler was done which showed a positive 'halo sign' and right temporal artery biopsy was compatible with the diagnosis of giant cell arteritis (GCA).