• Neth J Med · Apr 1993

    Review Case Reports

    Giant-cell arteritis with normal erythrocyte sedimentation rate: case report and review of the literature.

    • S Zweegman, B Makkink, and C D Stehouwer.
    • Department of Internal Medicine, Free University Hospital, Amsterdam, Netherlands.
    • Neth J Med. 1993 Apr 1; 42 (3-4): 128-31.

    AbstractA high Erythrocyte Sedimentation Rate (ESR) is often seen as a sine qua non for the diagnosis of giant-cell arteritis. The percentages of histopathologically proven giant-cell arteritis associated with a normal ESR, however, are variously reported as 5 to 30%. We describe a patient with histopathologically proven giant-cell arteritis and a normal ESR. A review of literature identified 34 cases of giant-cell arteritis who showed a normal ESR. Their clinical symptoms and signs are compared with the characteristics of patients with giant cell arteritis and an elevated ESR. No distinctive clinical features were found. A normal ESR cannot be used to exclude the diagnosis of giant-cell arteritis.

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