Abstract
A 65-year-old woman with rheumatological symptoms and diplopia was diagnosed as suffering from giant cell arteritis. Four years later she presented to us with a steroid responsive optic neuropathy. A presumptive diagnosis of neurosarcoidosis was made because of a gallium-67 single-photon emission tomography scan indicating a positive ‘panda sign’. Subsequent chest computerised tomographic imaging revealed cavitating lung lesions and an open biopsy established the diagnosis of Wegener granulomatosis despite the negative anti-neutrophilic cytoplasmic antibody. At the time of diagnosis the patient had a steroid responsive optic neuropathy and had recently developed a bilateral uveitis. Treatment with cyclophosphamide and corticosteroids produced complete remission with no further progression of disease.
ACKNOWLEDGEMENT
Research to Prevent Blindness (RPB) provided unrestricted research support.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Note: , , and of this article are available in colour online at www.informahealthcare.com/oph