Temporal arteritis in a patient with eosinophilia

Abstract

We present the case of a 69-year-old man with fever of unknown origin, headache, elevated sedimentation rate and peripheral eosinophilia. A biopsy of the temporal artery revealed transmural inflammation with eosinophilia. Therapy with corticosteroids resulted in resolution of the fever, headache, and eosinophilia, as well as normalization of the sedimentation rate. There have been only rare cases of eosinophilia associated with temporal arteritis. All of these cases were seen in patients with either juvenile temporal arteritis, acquired immunodeficiency syndrome, or Buerger's disease. This is the only case, to our knowledge, of eosinophilic temporal arteritis without association with any of these conditions. Our patient underwent extensive diagnostic studies and therapeutic trials en route to a long delayed correct diagnosis. The presence of eosinophilia should not deter physicians from considering a temporal artery biopsy in patients presenting with symptoms suggestive of temporal arteritis.