Patient, female, 66 years old, with personal history of Crohn's disease diagnosed 10 years ago and genital grade III.
She came to the consultation for presenting clinical symptoms of 4 months of evolution, of pain and slight rigidity in the muscles of scapular and pelvic girdle.
He did not complain of headache, visual symptoms or jaw claudication.
One month before the visit, she had undergone hysterectomy and grade III uterine colpoperineoplasty.
The microscopic description of the uterine body revealed arterial vessels with walls and granulomatous inflammation with giant cells, without necrosis, at the level of the medial and perivascular layers. A clinical study is recommended.
Physical examination revealed a patient with normal skin and mucous color.
Cardiac and pulmonary anodyne formation.
Abdomen blando, depresible, painless to palpation, hysterectomy scar with good appearance.
No masses.
No lymphadenopathy or malignant oedema
Peripheral pulses were preserved.
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On blood count, hematocrit was 5% and hemoglobin 11'9 g/dl, white blood cell count and hemostasis were normal.
ESR 52 mm/1 hour and CRP 66.3 g/dl. Biochemistry and urine sediment were normal.
RF, ANA and ANCA were negative.
HLA B27 positive.
Proteinogram normal.
Mantoux negative.
Chest X-ray: no cardiomegaly, normal lung fields.
A negative biopsy of the left temporal artery was performed.
With the diagnosis of GCA, treatment with Prednisone 1 mg/kg/day was started.
Two months later, the patient was asymptomatic, receiving a dose of 20 mg/day.
