TY - JOUR
T1 - Ocular manifestation of giant cell arteritis vs AL-amyloidosis
T2 - similar presentations but different approaches
AU - Azarfar, Azin
AU - Sharma, Aman
AU - Parikh, Jignesh G.
AU - Shaikh, Naazli M.
AU - King-Morris, Kelli
N1 - Funding Information:
No specific funding was received from any bodies in the public, commercial or not-for-profit sectors to carry out the work described in this manuscript.
Publisher Copyright:
© 2020 Japan College of Rheumatology.
PY - 2021
Y1 - 2021
N2 - Light chain (AL) amyloidosis may present with the features of vasculitis, including giant cell arteritis (GCA). Similarities between GCA and AL-amyloidosis can potentially cause confusion in diagnosis, in which case, temporal artery biopsy (TAB) should be performed to make a definitive diagnosis. Herein we report a case of a bilateral anterior ischaemic optic neuropathy (AION), showing evidence of AL-amyloidosis on the temporal artery biopsy. A 75-year-old male with AL-amyloidosis secondary to monoclonal gammopathy of undetermined significance (MGUS) presented to our hospital for subacute painless progressive visual impairment. Based on his elevated inflammatory markers and his age, he was suspected to have giant cell arteritis. However, a temporal artery biopsy excluded GCA, and the Congo red staining was positive for amyloid deposition. This present case reveals that AL-amyloidosis may present with visual impairment, high inflammatory markers, and involvement of temporal arteries, concerning for GCA. TAB with Congo red staining is found to be crucial for making the correct diagnosis.
AB - Light chain (AL) amyloidosis may present with the features of vasculitis, including giant cell arteritis (GCA). Similarities between GCA and AL-amyloidosis can potentially cause confusion in diagnosis, in which case, temporal artery biopsy (TAB) should be performed to make a definitive diagnosis. Herein we report a case of a bilateral anterior ischaemic optic neuropathy (AION), showing evidence of AL-amyloidosis on the temporal artery biopsy. A 75-year-old male with AL-amyloidosis secondary to monoclonal gammopathy of undetermined significance (MGUS) presented to our hospital for subacute painless progressive visual impairment. Based on his elevated inflammatory markers and his age, he was suspected to have giant cell arteritis. However, a temporal artery biopsy excluded GCA, and the Congo red staining was positive for amyloid deposition. This present case reveals that AL-amyloidosis may present with visual impairment, high inflammatory markers, and involvement of temporal arteries, concerning for GCA. TAB with Congo red staining is found to be crucial for making the correct diagnosis.
KW - Amyloidosis
KW - giant cell arthritis
KW - monoclonal gammopathy
KW - visual impairment
UR - http://www.scopus.com/inward/record.url?scp=85135818762&partnerID=8YFLogxK
U2 - 10.1080/24725625.2020.1804662
DO - 10.1080/24725625.2020.1804662
M3 - Article
C2 - 32787554
AN - SCOPUS:85135818762
SN - 2472-5625
VL - 5
SP - 117
EP - 122
JO - Modern Rheumatology Case Reports
JF - Modern Rheumatology Case Reports
IS - 1
ER -