Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report

Differentiating GCA from its many mimickers remains a challenge in the daily clinical practice, especially in patients presenting with unspecific manifestations. We present the case of an 82-year-old woman who presented with a 3-week history of left eye vision loss secondary to bilateral edema and hemorrhage of the optic discs. Despite negative bilateral temporal artery biopsies, the elevation of the inflammatory markers and brain MRA findings suggestive of temporal arteritis as well as stenosis of the basilar artery led us to initiate treatment with high-dose steroids. Inflammatory markers remained elevated despite high-dose steroids which prompted additional work leading to a diagnosis of varicella-zoster encephalitis. Steroid treatment was quickly tapered off and treatment with acyclovir resulted in the normalization of the acute phase reactants. The persistence of elevated inflammatory markers despite high-dose steroids should prompt additional work up for the search of an alternative diagnosis of GCA mimickers.

Location
Deutsche Nationalbibliothek Frankfurt am Main
Extent
Online-Ressource
Language
Englisch

Bibliographic citation
Ischemic Optic Neuropathy Secondary to Varicella-Zoster Vasculitis Mimicking Giant Cell Arteritis: Case Report ; volume:14 ; number:3 ; year:2022 ; pages:483-490 ; extent:8
Case reports in neurology ; 14, Heft 3 (2022), 483-490 (gesamt 8)

Creator
Rodriguez-Pla, Alicia
Grill, Marie F.
Fletcher, Geoffrey P.
Di Nome, Marie A.

DOI
10.1159/000527876
URN
urn:nbn:de:101:1-2023010423211348895565
Rights
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Last update
15.08.2025, 7:21 AM CEST

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Associated

  • Rodriguez-Pla, Alicia
  • Grill, Marie F.
  • Fletcher, Geoffrey P.
  • Di Nome, Marie A.

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