Dry Nonproductive Cough as the Presenting Symptom of Giant Cell Arteritis.

Abstract

G iant cell arteritis (GCA) is a systemic vasculitis affecting medium-sized and large-sized vessels. The disease most commonly affects the cranial branches of arteries originating from the aortic arch (1). Common presenting symptoms include headache, low-grade fever, scalp tenderness, and jaw claudication (1). However, the most feared complication is vision loss. Respiratory symptoms such as cough, sore throat, and hoarseness are less common but may occur in up to 9 percent of cases (2). Rarely, these features may be the sole presenting sign and can delay the diagnosis. We present a case of a 75-year-old man who had nonproductive, dry cough as the presenting symptom of GCA but eventually developed more typical symptoms of GCA including bilateral (no light perception) vision loss. Although GCA is known to present with either upper respiratory symptoms and/or bilateral, simultaneous complete blindness, to the best of our knowledge this is the first such case to be described in the English language ophthalmic literature.