Open AccessDo We Have a Culprit? An Association of Giant Cell Arteritis with Pulmonary Embolism
Author(s) -
Carolina Miguel Gonçalves,
Pedro Tavares,
Fátima Saraiva,
João Morais,
Maria Jesus Banza
Publication year - 2022
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2021_003028
Subject(s) - medicine , giant cell arteritis , pulmonary embolism , polymyalgia rheumatica , radiology , vasculitis , pulmonary angiography , physical examination , chest pain , surgery , disease
Giant cell arteritis is the most common type of systemic vasculitis. An increased risk of venous thromboembolism has been described in these patients. We report the case of a 79-year-old woman with a history of polymyalgia rheumatica, who presented with left thoracic pain radiating to the neck and scapula plus temporal headache. She had no changes on physical examination, but work-up tests showed increased D-dimer levels and computed tomography pulmonary angiography revealed signs of a chronic/subacute embolism in the right inferior lobe. Anticoagulation with edoxaban was started after 5-day bridging with enoxaparin. Three weeks after the initial diagnosis the headache still persisted and she developed scalp tenderness. Giant cell arteritis was diagnosed and treated with prednisolone, with complete resolution of symptoms. Extensive diagnostic work-up was performed to identify an alternative cause of pulmonary thromboembolism; however, the investigations were negative. This case supports the hypothesis that this type of vasculitis could be related to the occurrence of pulmonary embolism.