{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T23:05:16Z","timestamp":1775862316081,"version":"3.50.1"},"reference-count":13,"publisher":"SMC Media","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are both rheumatological diseases of the elderly with a strong association with each other and which rarely present with normal inflammatory markers. Here we present the case of a 61-year-old Caucasian woman who had typical symptoms of both diseases. At the time of presentation, her blood work showed normal inflammatory markers, but because of the high clinical suspicion for GCA, a temporal artery biopsy was done which was positive for giant cells and disruption of the internal elastic lamina. Our patient responded very well to treatment with oral steroids and steroid-sparing medication and was able to return to her normal life without experiencing any complications of the disease. By sharing our case, we aim to increase the awareness of medical personnel regarding the importance of focusing on the clinical presentation as well as the laboratory and pathological aspects of diagnosing GCA and PMR.<\/jats:p>","DOI":"10.12890\/2022_003192","type":"journal-article","created":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T05:57:17Z","timestamp":1645423037000},"source":"Crossref","is-referenced-by-count":7,"title":["Normal ESR, CRP and Platelet Count in Giant Cell Arteritis and Polymyalgia Rheumatica: A Diagnostic Conundrum"],"prefix":"10.12890","volume":"9","author":[{"given":"Abdullahi","family":"Elsheikh Mahgoub","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2632-8277","authenticated-orcid":false,"given":"Sophia","family":"Tessema","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wayne State University, Detroit, MI, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7719-0135","authenticated-orcid":false,"given":"Rasha","family":"Nakhleh","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, OR, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10397","published-online":{"date-parts":[[2022,2,21]]},"reference":[{"key":"10.12890\/2022_003192_ref1","doi-asserted-by":"crossref","unstructured":"<li>Maz M, Chung SA, Abril A, Langford CA, Gorelik M, Guyatt G, et al. 2021 American College of Rheumatology\/Vasculitis Foundation guideline for the management of giant cell arteritis and Takayasu arteritis. <em>Arthritis Rheumatol<\/em> 2021;<strong>73<\/strong>(8):1349\u20131365.<\/li>","DOI":"10.1002\/art.41774"},{"key":"10.12890\/2022_003192_ref2","doi-asserted-by":"crossref","unstructured":"<li>Gonz\u00e1lez-Gay MA, Matteson EL, Casta\u00f1eda S. Polymyalgia rheumatica. <em>Lancet<\/em> 2017;<strong>390<\/strong>(10103):1700\u20131712.<\/li>","DOI":"10.1016\/S0140-6736(17)31825-1"},{"key":"10.12890\/2022_003192_ref3","doi-asserted-by":"crossref","unstructured":"<li>Hunder GG, Bloch DA, Michel BA, Stevens MB, Arend WP, Calabrese LH, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. <em>Arthritis Rheum<\/em> 1990;<strong>33<\/strong>(8):1122\u20131128.<\/li>","DOI":"10.1002\/art.1780330810"},{"key":"10.12890\/2022_003192_ref4","doi-asserted-by":"crossref","unstructured":"<li>Turesson C, B\u00f6rjesson O, Larsson K, Mohammad AJ, Knight A. 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BSR and BHPR guidelines for the management of giant cell arteritis. <em>Rheumatology (Oxford)<\/em> 2010;<strong>49<\/strong>(8):1594\u20131597.<\/li>","DOI":"10.1093\/rheumatology\/keq039a"},{"key":"10.12890\/2022_003192_ref7","doi-asserted-by":"crossref","unstructured":"<li>Chan FLY, Lester S, Whittle SL, Hill CL. The utility of ESR, CRP and platelets in the diagnosis of GCA. BMC Rheumatol 2019;3(1):14.<\/li>","DOI":"10.1186\/s41927-019-0061-z"},{"key":"10.12890\/2022_003192_ref8","doi-asserted-by":"crossref","unstructured":"<li>Smetana GW, Shmerling RH. Does this patient have temporal arteritis? <em>JAMA<\/em> 2002;<strong>287<\/strong>(1):92\u2013101.<\/li>","DOI":"10.1001\/jama.287.1.92"},{"key":"10.12890\/2022_003192_ref9","doi-asserted-by":"crossref","unstructured":"<li>Cheema MR, Ismaeel SM. Temporal arteritis with erythrocyte sedimentation rate <50 mm\/h: a clinical reminder. <em>Clin Interv Aging<\/em> 2016;<strong>11<\/strong>:185\u2013188.<\/li>","DOI":"10.2147\/CIA.S40919"},{"key":"10.12890\/2022_003192_ref10","doi-asserted-by":"crossref","unstructured":"<li>Singh R, Sahbudin I, Filer A. New headaches with normal inflammatory markers: an early atypical presentation of giant cell arteritis. <em>BMJ Case Rep<\/em> 2018;<strong>2018<\/strong>:bcr2017223240.<\/li>","DOI":"10.1136\/bcr-2017-223240"},{"key":"10.12890\/2022_003192_ref11","doi-asserted-by":"crossref","unstructured":"<li>Walters B, Lazic D, Ahmed A, Yiin G. Lessons of the month 4: Giant cell arteritis with normal inflammatory markers and isolated oculomotor nerve palsy. <em>Clin Med<\/em> 2020;<strong>20<\/strong>(2):224\u2013226.<\/li>","DOI":"10.7861\/clinmed.2019-0504"},{"key":"10.12890\/2022_003192_ref12","doi-asserted-by":"crossref","unstructured":"<li>Salvarani C, Hunder GG. Giant cell arteritis with low erythrocyte sedimentation rate: frequency of occurence in a population-based study. <em>Arthritis Rheum<\/em> 2001;<strong>45<\/strong>(2):140\u2013145.<\/li>","DOI":"10.1002\/1529-0131(200104)45:2<140::AID-ANR166>3.3.CO;2-U"},{"key":"10.12890\/2022_003192_ref13","doi-asserted-by":"crossref","unstructured":"<li>Kermani TA, Schmidt J, Crowson CS, Ytterberg SR, Hunder GG, Matteson EL, et al. Utility of erythrocyte sedimentation rate and C-reactive protein for the diagnosis of giant cell arteritis. <em>Semin Arthritis Rheum<\/em> 2012;<strong>41<\/strong>(6):866\u2013871.<\/li>","DOI":"10.1016\/j.semarthrit.2011.10.005"}],"container-title":["European Journal of Case Reports in Internal Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3192\/3015","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3192\/3016","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/download\/3192\/3016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T11:52:46Z","timestamp":1755863566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ejcrim.com\/index.php\/EJCRIM\/article\/view\/3192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,21]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.12890\/2022_003192","relation":{"has-manifestation":[{"id-type":"other","id":"1-82-3192-g3015","asserted-by":"subject"},{"id-type":"other","id":"1-82-3192-g3016","asserted-by":"subject"}],"is-part-of":[{"id-type":"other","id":"1-82","asserted-by":"subject"}]},"ISSN":["2284-2594"],"issn-type":[{"value":"2284-2594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,21]]},"article-number":"10"}}