I've just had an ultrasound on both temples which is not showing active inflammation yet I've had a terrible night with excruciating headache on bilateral temples. I felt dreadful during the night sweats on and off as well.
I've just finished a week of 40mg pred, dropping to 20 mg today.
After taking meds this morning my headache eased straight away, so I'm confused 😕
Could it be anything else.
I'm starting tocilizumab beginning of November.
Thank you
Written by
Pamela60
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Hopefully PMRPro will be along soon with her invaluable advice.
For what it is worth, had I had a night like that I would have called an ambulance or at least protected myself with more Prednisalone. I would not taper at present and seek medical advice about temporarily increasing my dose. The big worry is your eyesight. Report everything to your doctor.
I feel OK now just washed out. I thought of increasing dosage but then received results of uss saying no active inflammation. It flummoxed me and thought is it all in my mind.
A small percentage of patients do not show inflammation in their bloods, unfortunately and whilst on Pred it is being controlled. It is better to be safe than sorry. I am so glad that you are out of pain. I would have taken the efficacy of Pred as a sign that it was GCA. Do not tolerate another night like that - please.
Impossible to say - except I don't know the u/s functions with regard to skip lesions: GCA doesn't affect the artery evenly and it may be affecting an area they didn't couldn't look at.
Why did they say drop the pred dose when they are putting you on to tocilizumab? Or why are they waiting another few weeks?
As you probably know, ultrasounds for GCA can vary in their accuracy depending on the operator. So it is possible you have a false negative. The Bristol Symposium Review indicates that of those who received a positive biopsy, 49% presented with a headache, it being the most common symptom (Table 4), but a headache alone only represents 46% positive predictive value. rcpe.ac.uk/sites/default/fi...
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