SYSTEMIC AMYLOIDOSIS WITH TEMPORAL ARTERY INVOLVEMENT MIMICKING TEMPORAL ARTERITIS

A 77-year-old man presented with jaw claudication, arthralgias and mya lgias, weight loss, marked fatigue, and thickened temporal arteries. N o vasculitis was seen on the temporal artery biopsy specimen, but amyl oidosis was suspected and confirmed with Congo red staining. Subsequen t bone marrow biopsy revealed multiple myeloma. Although the patient i nitially was thought to have temporal arteritis, the results of tempor al artery biopsy directed further investigations that led to the diagn osis of systemic amyloidosis. Systemic amyloidosis should be considere d in the differential diagnosis when patients, especially men, present with clinical findings suggestive of temporal arteritis but without e vidence of vasculitis in temporal artery biopsy specimens.