Giant cell arteritis exclusively detected by 18F-fluorodeoxyglucose positron emission tomography: A case report

Brückner M., Bettenworth D., Hengst K., Weckesser M., Willeke P., Heidemann J.

Research article (journal) | Peer reviewed

Abstract

Introduction: This case of giant cell arteritis is noteworthy because it evaded standard diagnostic criteria and only emerged as fever of unknown origin. In this regard, we present 18F-fluorodeoxyglucose positron emission tomography as a valid diagnostic method. Case presentation: This case report describes a 58-year-old Caucasian woman who is a cigarette smoker with a 10-week history of fever of unknown origin, night sweats and weight loss of 12kg. Initially, clinical presentation was suspicious of malignant disease. Laboratory findings detected significantly elevated inflammatory blood parameters including C-reactive protein and elevated erythrocyte sedimentation rate (110mm/hour). Extensive diagnostic workup including microbiological and rheumatological assessment, ultrasonography, endoscopy and computed tomography of abdomen and thorax did not indicate any septic or malignant focus. Eventually, 18F-fluorodeoxyglucose positron emission tomography was able to reveal arteritis of her aortic arch and supraaortic branches. Subsequently, she commenced steroid and methotrexate therapy that led to sustained remission. Conclusions: This case of giant cell arteritis may promote discussion regarding a more specific classification for this disease entity. Furthermore, it confirms that 18F-fluorodeoxyglucose positron emission tomography might serve as a valuable tool for diagnosis of giant cell arteritis, because it could facilitate an accurate and non-invasive detection of lesions of large vessels.

Details about the publication

JournalJournal of Medical Case Reports (J Med Case Reports)
Volume8
Issue1
StatusPublished
Release year2014
Language in which the publication is writtenEnglish
DOI10.1186/1752-1947-8-356
Link to the full texthttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84937555545&origin=inward
Keywords18F-FDG PET; 18F-fluorodeoxyglucose positron emission tomography; Fever of unknown origin; Giant cell arteritis; Large vessel vasculitis

Authors from the University of Münster

Bettenworth, Dominik
Medical Clinic of Internal Medicine B: Gastroenterology and Metabolic Disorders (Med B)
Brückner, Markus Georg
Medical Clinic of Internal Medicine B: Gastroenterology and Metabolic Disorders (Med B)
Weckesser, Jochen Matthias
Clinic for Nuclear Medicine