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Temporal Arteritis—Dysphagia and a Normal ESR

Peter Watson, MD, FRCP(C)
JAMA. 1984;252(10):1280-1281. doi:10.1001/jama.1984.03350100014012.
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To the Editor.—  Temporal arteritis (TA) may be seen in unusual ways.1,2 This patient's case is reported because of its singular nature, particularly the prominent dysphagia. Earlier treatment might have prevented the subsequent tragic visual loss.

Report of a Case.—  A 66-year-old woman sustained blindness in the left eye four days before to admission. On admission, she had the funduscopic findings of central retinal artery occlusion on the left. She had not suffered headache, myalgia, weight loss, fever, malaise, or jaw claudication. Her only other complaint was discomfort on swallowing of two weeks' duration, to such a degree that she took only tepid fluids. The superficial temporal artery was nontender and weakly palpable bilaterally. Her ESR (Westergren) was 18 and 4 mm/hr on separate occasions, measured within an hour of the blood sample being taken. She was not anemic. On the second hospital day she complained of transient obscuration


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