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Temporal Arteritis With Normal ESR

L. R. Espinoza, MD; C. G. Espinoza, MD
Arch Intern Med. 1980;140(2):281-282. doi:10.1001/archinte.1980.00330140139041.
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To the Editor.  —Esposito and Gleckman, in the May issue of the Archives (139:575-579, 1979), provide an excellent review of the diagnostic approach in patients with fever of unknown origin (FUO); however, they have failed to call attention to the presence of a normal ESR in some patients with temporal arteritis.1-2 An elevated ESR is almost a constant finding in temporal arteritis patients, and it is of great diagnostic help, especially in the early phases of the disease. However, a normal ESR can be seen in some patients and does not exclude the diagnosis of temporal arteritis. The following case illustrates the coexistence of temporal arteritis and a normal ESR.

Report of a Case.  —A 71-year-old woman was admitted to our medical center with fever, headache, and malaise. Her illness had begun ten weeks previously, with anorexia, malaise, weight loss, and temperatures up to 40 °C. At the time


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