Giant-cell arteritis with normal erythrocyte sedimentation rate: case report and review of the literature

Neth J Med. 1993 Apr;42(3-4):128-31.


A high Erythrocyte Sedimentation Rate (ESR) is often seen as a sine qua non for the diagnosis of giant-cell arteritis. The percentages of histopathologically proven giant-cell arteritis associated with a normal ESR, however, are variously reported as 5 to 30%. We describe a patient with histopathologically proven giant-cell arteritis and a normal ESR. A review of literature identified 34 cases of giant-cell arteritis who showed a normal ESR. Their clinical symptoms and signs are compared with the characteristics of patients with giant cell arteritis and an elevated ESR. No distinctive clinical features were found. A normal ESR cannot be used to exclude the diagnosis of giant-cell arteritis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Blood Sedimentation*
  • Female
  • Giant Cell Arteritis / blood*
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / pathology
  • Headache / complications
  • Humans
  • Male
  • Middle Aged