18th January 2024

A 72-year-old woman with a past medical history of diabetes and a renal transplant presents to the emergency department with a severe headache and vision loss in her left eye.

A 72-year-old woman with a past medical history of diabetes and a renal transplant presents to the emergency department with a severe headache and vision loss in her left eye. She reports a several-day history of scalp tenderness and jaw pain, along with fatigue and low-grade fever. On physical examination, she has a tender, palpable temporal artery and reduced visual acuity in her left eye. You note that she has a raised BMI. Her renal transplant is non-tender on examination.

Which of the following puts the patient at higher risk of treatment resistance?

Select the SINGLE most appropriate option from the list below. Select ONE option only.