Correspondence
Infectious keratitis as the presenting sign of giant cell arteritis
Giant cell arteritis (GCA) is a medium-to-large vessel vasculitis that usually presents with headache, loss of vision, jaw claudication, and scalp tenderness. We report a case of biopsy-consistent GCA presenting as an infectious bacterial keratitis. To our knowledge, this is the first such case reported in the English-language ophthalmic literature.Giant cell arteritis relapse presenting as idiopathic orbital inflammation
Giant cell arteritis (GCA) is a systemic vasculitis that can cause permanent vision loss. Even after treatment, relapses have been reported in 40%–64% of patients, depending on how relapses are defined.1,2 Here, we present a rare case of a GCA relapse mimicking idiopathic orbital inflammation (IOI) on the side contralateral to the initial episode of the disease. Simultaneous, positive biopsies of the orbit and temporal arteries were obtained, offering histological evidence that the orbital inflammation and GCA flare were linked.Optic neuropathy in extramedullary, blast crisis of chronic myeloid leukemia
Chronic myeloid leukemia (CML) represents 10%–20% of all leukemias. Vision loss in patients with CML is usually related directly to the disease (CML) or less likely to potential side effects of the treatment of CML (e.g., radiotherapy or chemotherapy). Extramedullary CNS or meningeal blast crisis in CML is an uncommon but well-known complication of CML. Visual loss in CML typically occurs with abnormal serum white blood cell (WBC) count, peripheral blood smear, bone marrow biopsy, cerebrospinal fluid (CSF) analysis, or neuroimaging.Elevated lipoprotein(a) levels as the cause of cryptogenic stroke in a young Ashkenazi Jewish female
Lipoprotein(a) is a cholesterol carrier molecule, structurally similar to low-density lipoprotein (LDL), but with distinct properties predisposing it to associations with increased risk of stroke, myocardial infarction (MI), and aortic stenosis.1–4 However, lipoprotein(a) levels are not routinely checked, although there is a known pattern of genetic inheritance.5 We present a case of a young patient with purported cryptogenic stroke and a family history of cardiovascular disease, which was attributed to elevated lipoprotein(a) levels.
