Conference Proceedings

OVERLAPPING SYNDROME OF GIANT CELL ARTERITIS AND ANCA-ASSOCIATED VASCULITIS COMPLICATED BY SEVERE AXONAL NEUROPATHY: A CASE REPORT

Laura Perju-Dumbrava, Fariha Islam, Rohitha Makonahalli, Catriona McLean, Hedley Griffiths, Abhishek Malhotra

Journal of Neurology Neurosurgery & Psychiatry | BMJ PUBLISHING GROUP | Published : 2019

Abstract

CaseA 61-year- old woman presented with what was thought to be a refractory, temporal artery biopsy-proven giant cell arteritis (GCA). After 4 months of therapy she was unable to get the prednisolone dose below 40 mg/day, so weekly subcutaneous Tocilizumab was introduced but with minimal response after 8 weeks. She was then admitted to hospital with a severe rapidly progressive length dependent sensorimotor peripheral neuropathy. Nerve conduction studies showed predominantly an axonal neuropathy with multiple pseudo-conduction blocks.Sural nerve and gastrocnemius biopsies revealed a necrotising vasculitis with numerous giant cells and active axonal degeneration. She proved to be ANCA-PR3 pos..

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