Litwin and colleagues have correctly pointed out that there are many explanations for a normal sedimentation rate in patients with inflammatory diseases such as giant cell arteritis. Unfortunately, many physicians, including the physicians involved in the treatment of the patient described in our article,1 do not realize that a normal sedimentation rate can be seen in this setting. Treatment was delayed several weeks in our patient, and the disastrous complications could possibly have been avoided had the doctors been aware, as Litwin and colleagues are, that the sedimentation rate is only an adjunct in making the diagnosis of giant cell arteritis.
Sergent JS. Normal Sedimentation Rates and Giant Cell Arteritis-Reply. Arch Intern Med. 1992;152(1):209. doi:10.1001/archinte.1992.00400130197037