Giant-cell Arteritis of the Ovarian Arteries: A Rare Manifestation of a Common Disease.

We describe a 58-year-old woman presenting with headache and an elevated erythrocyte sedimentation rate (ESR), who was diagnosed with and successfully treated for giant-cell arteritis (GCA). Seven months after the end of treatment, ovarian GCA was incidentally found after ovariectomy for a simple cyst. GCA of extracranial vessels like the ovarian arteries is rare. Nevertheless, we stress that extracranial GCA should be considered in patients older than 50 years with an elevated ESR, even if a temporal artery biopsy is negative or specific symptoms are absent. Moreover, we discuss the importance of imaging techniques when GCA of the extracranial large vessels is suspected. LEARNING POINTS: Although rare, ovarian arteries can be involved in giant-cell arteritis (GCA).Extracranial GCA should be considered in the differential diagnosis of patients aged 50 years or older with an elevated ESR, even if temporal artery biopsy is negative or specific symptomatology of GCA is absent.If GCA is suspected but the origin is unclear, an MRA or PET-CT scan should be performed to screen for GCA of extracranial arteries.

[Endovascular stenting in a stenotic solitary kidney; renal failure due to atherosclerotic renal artery stenosis]. / Stentplaatsing bij een stenotische mononier: nierfunctiestoornis door atherosclerotische nierarteriestenose.

In this article we present three patients with atherosclerotic renal artery stenosis in a solitary kidney. They developed progressive renal failure, hypertension or fluid overload which were resistant to drug therapy. As there were no other therapeutic options they were treated with renal artery stenting, with good clinical results. Although large trials have not shown that endovascular stenting has any advantages over medical therapy in atherosclerotic renal artery stenosis, we propose that if other options fail there is a place for stenting in renal artery stenosis in patients with a single functioning kidney.

Loss of vision as a presenting sign of cobalamin deficiency: An eye-opener.

We describe a patient who presented with loss of vision that turned out to be caused by cobalamin deficiency. Both her vision and her visual field improved upon supplementation of cobalamin. It is, therefore, important to consider cobalamin deficiency as a treatable cause of loss of vision.