Case Report Giant Cell Arteritis in a 12-Year-Old Girl Presenting with Nephrotic Syndrome Zeinab A. El-Sayed, 1 Hanaa M. El-Awady, 1 Zeinab E. Hassan, 1 Tamer M. H. Adham, 1 Hossam M. Mostafa, 1 and Nadia G. Elhefnawy 2 1 Pediatric Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 11566, Egypt 2 Pathology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 11566, Egypt Correspondence should be addressed to Zeinab A. El-Sayed; zeinabawad@med.asu.edu.eg Received 22 July 2014; Revised 3 October 2014; Accepted 3 October 2014; Published 21 October 2014 Academic Editor: Masataka Kuwana Copyright © 2014 Zeinab A. El-Sayed et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Giant cell arteritis (GCA) is rare in children. he kidneys are generally spared. We present a case of GCA in a 12-year-old girl with severe headache and tender scalp especially over the right temporal area. he right supericial temporal artery was cord like and nodular and the pulsations were barely felt. Several small tender nodular swellings were felt in the occipital area. She had been previously diagnosed as a case of nephrotic syndrome due to underlying membranoproliferative glomerulonephritis. his report is aimed at drawing attention to this rare form of vasculitis in children aiming at decreasing its morbidities. 1. Introduction Temporal arteritis, also known as giant cell arteritis (GCA), is a systemic, inlammatory vascular syndrome predominantly afecting the cranial arteries. It is rare in children [1]. Eye complications occur at about 3 months and include partial or total blindness, amaurosis fugax, and, on occasion, sudden extraocular muscle dysfunction [2, 3]. he lungs, the abdom- inal viscera, and the skin may also be involved [3–5]. GCA generally spares the kidneys. However, renal involvement does occur, usually presenting as renovascular hypertension [3]. he diagnosis is a clinical one conirmed with a temporal artery biopsy. In 10–42% of patients eventually diagnosed with GCA, the arteries, by biopsy, do not show signs of inlammation [2, 4], the so-called biopsy negative GCA [6, 7]. 2. Case Report A 12-year-old girl presented to the Outpatient Clinic of Children’s Hospital, Ain Shams University, Egypt, complain- ing of severe headache and tenderness over the scalp and right temporal area extending to the occipital region, of gradual onset, progressive course, and a 3-month duration. he headache was bursting, having its summit ater school days, and was not associated with vomiting or blurring of vision. Ever since birth, the child was normal. At the age of 9, she sufered recurrent attacks of generalized edema diagnosed at another hospital as nephrotic syndrome for which she received several courses of daily oral prednisone at doses reaching 1.5 mg/kg. he response was incomplete but the patient’s mother admitted that her daughter’s compliance to therapy was poor and was of therapy for the preceding 2 months. he child experienced frequent attacks of vertigo, fatiga- bility, and bilateral knee arthralgia. here were no claudica- tions, no Raynaud’s phenomenon, and no history of rashes or photosensitivity or other system involvement. here was no history of a preceding viral infection or drug intake, and the patient denied any previous contact with animals. he family history was irrelevant. On examination, her general condition was fair; she was fully conscious with pufy eyelids. Her temperature and respiratory rate were normal, but her radial pulse was bounding regularly at a rate of 86/minute and was equal on both sides. Her BP, measured at the arms, was 140/100 mmHg. Her weight was 30 kg and her height was 130 cm. he patient had a cord like nodular right supericial temporal artery Hindawi Publishing Corporation Case Reports in Rheumatology Volume 2014, Article ID 491937, 4 pages http://dx.doi.org/10.1155/2014/491937