Giant Cell Arteritis Mimicking Multiple Myeloma; Diagnosed by PET Scan
Giant Cell Arteritis Mimicking Multiple Myeloma; Diagnosed by PET Scan
This case report describes a patient who presented with severe anemia, monoclonal gammopathy, a high erythrocyte sedimentation rate and significant weight loss. These features were highly suggestive of multiple myeloma. Bone marrow aspiration was negative for myeloma on two occasions. A positron emission tomography (PET) scan showed extensive 2-flourodeoxy-glucose uptake in the vascular tree consistent with arteritis. A temporal artery biopsy established the diagnosis of giant cell arteritis (GCA). There were no typical symptoms of GCA, such as headache, visual disturbance, or polymyalgia rheumatica. The patient was treated with steroids, which resulted in the resolution of anemia, monoclonal gammapathy, and other symptoms.
Giant cell arteritis (GCA) is a systemic vasculitis that usually presents with headache, scalp tenderness, visual disturbances, weight loss, and a very high erythrocyte sedimentation rate. Diagnosis is usually established by temporal artery biopsy. PET scan has been used in the diagnosis and for the follow up of the treatment of giant cell arteritis. Our patient presented with rather severe anemia, significant weight loss, and monoclonal gammapathy. She did not have typical symptoms of giant cell arteritis, such as headache or visual problems. These features were highly suspicious for myeloma. PET scan incidentally revealed findings consistent with arteritis, which was then confirmed by temporal artery biopsy.
Abstract and Introduction
Abstract
This case report describes a patient who presented with severe anemia, monoclonal gammopathy, a high erythrocyte sedimentation rate and significant weight loss. These features were highly suggestive of multiple myeloma. Bone marrow aspiration was negative for myeloma on two occasions. A positron emission tomography (PET) scan showed extensive 2-flourodeoxy-glucose uptake in the vascular tree consistent with arteritis. A temporal artery biopsy established the diagnosis of giant cell arteritis (GCA). There were no typical symptoms of GCA, such as headache, visual disturbance, or polymyalgia rheumatica. The patient was treated with steroids, which resulted in the resolution of anemia, monoclonal gammapathy, and other symptoms.
Introduction
Giant cell arteritis (GCA) is a systemic vasculitis that usually presents with headache, scalp tenderness, visual disturbances, weight loss, and a very high erythrocyte sedimentation rate. Diagnosis is usually established by temporal artery biopsy. PET scan has been used in the diagnosis and for the follow up of the treatment of giant cell arteritis. Our patient presented with rather severe anemia, significant weight loss, and monoclonal gammapathy. She did not have typical symptoms of giant cell arteritis, such as headache or visual problems. These features were highly suspicious for myeloma. PET scan incidentally revealed findings consistent with arteritis, which was then confirmed by temporal artery biopsy.
