Dementia as a presentation symptom of giant cell arteritis

Giant Cells Arteritis (GCA) can be presented sometimes with atypical manifestations which greatly difficult its diagnosis. We present a case of GCA in a 58-year-old man with dementia as first symptom. In the anamnesis, signs of rheumatic polymyalgia were observed, as well as a recently started dementia with a very disturbed mini-mental test. The analytic study showed anemia (Hb of 7.44 nmol/l, with 3.2 x 10(12) red cells and a GSR of 85 mm). The diagnosis of GCA was supported by a temporal biopsy. In a study of magnetic resonance, there were no evidences of brain infarct areas. After treatment with prednisone, normalization of GSR and a significant improvement of cortical functions were observed. GCA must be considered in the initial diagnosis of a patient with mental disorders, given that it is one of the curable causes of dementia.