Case Report

Giant Cell Arteritis Mimicking Multiple Myeloma; Diagnosed by PET Scan

Authors: Satheesh K. Kathula, MD, FACP, Joseph Mantil, MD, PHD, Timothy Drehmer, MD, FACP, Soma S. Patil, MD

Abstract

This case report describes a patient who presented with severe anemia, monoclonal gammopathy, a high erythrocyte sedimentation rate and significant weight loss. These features were highly suggestive of multiple myeloma. Bone marrow aspiration was negative for myeloma on two occasions. A positron emission tomography (PET) scan showed extensive 2-flourodeoxy-glucose uptake in the vascular tree consistent with arteritis. A temporal artery biopsy established the diagnosis of giant cell arteritis (GCA). There were no typical symptoms of GCA, such as headache, visual disturbance, or polymyalgia rheumatica. The patient was treated with steroids, which resulted in the resolution of anemia, monoclonal gammapathy, and other symptoms.


Key Points


* Giant cell arteritis may present with significant anemia, weight loss, high ESR, and monoclonal gammapathy and can mimic myeloma.


* Typical manifestations of GCA may be absent.


* PET scan may be used in the management of giant cell arteritis, but it does not replace the temporal artery biopsy for diagnosis.


* Treatment with steroids can result in the resolution anemia, monoclonal gammapathy, etc.

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