4.8 Article

Giant-Cell Arteritis and Polymyalgia Rheumatica

Journal

NEW ENGLAND JOURNAL OF MEDICINE
Volume 371, Issue 1, Pages 50-57

Publisher

MASSACHUSETTS MEDICAL SOC
DOI: 10.1056/NEJMcp1214825

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A 79-year-old woman presents with new-onset pain in her neck and both shoulders. She takes 7.5 mg of prednisone per day for giant-cell arteritis. Occipital tenderness and diplopia developed 11 months before presentation. At that time, her erythrocyte sedimentation rate was elevated, at 78 mm per hour, and a temporal-artery biopsy revealed granulomatous arteritis. The diplopia resolved after 6 days of treatment with 60 mg of prednisone daily. Neither headache nor visual symptoms developed when the glucocorticoids were tapered. How should this patient's care be managed?

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