Normal ESR, CRP and Platelet Count in Giant Cell Arteritis and Polymyalgia Rheumatica: A Diagnostic Conundrum

  • Abdullahi Elsheikh Mahgoub Department of Internal Medicine, Michigan State University at Hurley Medical Center, Flint, MI, USA
  • Sophia Tessema Department of Neurology, Wayne State University, Detroit, MI, USA
  • Rasha Nakhleh Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, Portland, OR, USA


Giant cell arteritis, polymyalgia rheumatica, inflammatory markers, ESR, CRP, vasculitis


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.



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  • Published: 2022-02-21

    Issue: 2022: Vol 9 No 2 (view)

    Section: Articles

    How to cite:
    Elsheikh Mahgoub A, Tessema S, Nakhleh R. Normal ESR, CRP and Platelet Count in Giant Cell Arteritis and Polymyalgia Rheumatica: A Diagnostic Conundrum. EJCRIM 2022;9 doi:10.12890/2022_003192.