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Query: UMLS:C0018681 (headache)
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Clinical and biological characteristics are studied in 16 patients with polymyalgia arteritica. 12 of them were diagnosed by biopsy of the temporal artery and the other 4 because they presented clinical, biological data and a high response to corticosteroids. There were no differences according to sex. Most patients (75%) had symptoms since 1-6 months, headache being the most common (75%). Fever (56%), polymyalgia (50%), weight loss (37%), intermittent claudication, loss of vision and arthritis (12%) were the symptoms seen in these patients. ERS was high in all cases, hemoglobin was less than 8 g/100 ml in 8 cases and an increase of alfa-2-globuline was found in 8 patients. Temporal artery palpation was abnormal in 11 patients. Two of 5 patients who presented a normal arterial palpation had a positive biopsy. All patients received 6-metil-prednisolone. 3 are well after 3, 4 and 6 months therapy. 8 are also well but receiving small doses of steroids as treatment.
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PMID:[Clinical course characteristics of polymyalgia arteritica. Study of 16 cases]. 55 25

Temporal arteritis (granulomatous inflammation) usually involves the temporal and ophthalmic arteries, but may be part of a more widespread inflammation of the medium and large vessels. The patient usually presents with an associated group of constitutional symptoms (fever, malaise, anorexia, weight loss, anemia) and rheumatic complaints (polymyalgia rheumatic complaints (polymyalgia rheumatica). The diagnosis should be considered in any patient over 55 years old in whom these symptoms develop or in whom there is evidence of recent onset of headache, visual loss of localized arterial involvement. The diagnosis is also to be considered when the erythrocyte sedimentation rate is over 50 mm/hr, and the presence of arteritis is confirmed by temporalartery biopsy findings. Visual loss may occur in 50 percent of affected patients; other serious complications are less common. A strong clinical suspicion of temporal arteritis will permit diagnosis of the more uncommon and atypical presentations of the syndrome. Although cases of temporal arteritis may be self-limited, treatment is imperative because of the threat of blindness. Patients respond well to steroid (prednisone) therapy, which should be maintained for a prolonged period.
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PMID:Temporal arteritis. 90 43

Ocular complications occurring in temporal arteritis are of different severities. These manifestations of the disease occurred in a population of 57 patients with diagnosis of temporal arteritis, in 16 of them (28%). The diagnosis was suggested by finding an inflammatory syndrome (high erythrocyte sedimentation rate) and confirmed by temporal artery biopsy. In making this diagnosis, it was helpful to find a history of characteristic temporal headaches, neckache, jaw claudication, fever and malaise or weight loss in addition to polymyalgia and polyarthralgia. 6 patients presented with diplopia and different ocular muscle or nerve palsies. The 10 others came for sudden loss of vision due to ischemic anterior or posterior neuropathy and in one case, central artery obliteration. Prompt treatment with steroids gave good results on oculomotor troubles and in preventing the risk of involvement of the fellow eye. But loss of vision did not regress with this treatment. That means the importance in making this diagnosis and starting very promptly this treatment.
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PMID:[Eye manifestations of Horton's disease]. 259 Sep 88

We have evaluated 100 biopsies of temporal artery carried out in the Hospital La Paz from 1972 to 1986. On the basis of the histological result and the final diagnosis we divided the patients in five groups: I, temporal arteritis/polymyalgia rheumatica with positive biopsy, 11 cases; II, temporal arteritis without polymyalgia symptoms and with positive biopsy, 16 cases; III, temporal arteritis with negative biopsy, 7 cases; IV, polymyalgia with negative biopsy, 14 cases; and V, other diagnoses, 43 cases. The number of diagnoses of temporal arteritis/polymyalgia rheumatica has increased throughout the recent years, although the positive biopsies/overall biopsies ratio has remained constant. Certain symptoms such as claudication, headache, amaurosis and Raynaud's phenomenon have a high predictive value of a positive result, but their sensitivity is low. In the 25 patients with polymyalgia, biopsy was positive in 11, out of which 4 did not have features of temporal arteritis. Biopsy was positive in 4 out of the 9 patients in whom it was repeated in the contralateral side. The diagnostic yield was higher in those cases in whom it was indicated for classical temporal arteritis symptoms, but we emphasize that there was a 19% positive rate in patients who presented with fever of unknown origin, while it was only 5.5% in those in whom a constitutional syndrome was being evaluated. We conclude that the use of temporal biopsy should be more widespread, as its cost is low and it has no side effects; therefore, it can achieve a great benefit for the patient with a shorter and less expensive hospital stay.
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PMID:[Usefulness of temporal artery biopsy: analysis of 100 cases]. 270

Polymyalgia rheumatica is a relatively common syndrome of older patients, mostly white, manifested by aching and morning stiffness of the pelvic and shoulder girdles and accompanied by a rapid erythrocyte sedimentation rate. The symptoms are due to a synovitis, which is mild, nondestructive and very responsive to low-dose steroid treatment, which may need to be continued for several years. Temporal arteritis, which may accompany polymyalgia, can present as headache, loss of vision, diplopia or jaw claudication. To suppress arterial inflammation and preserve vision, administration of prednisone, 50 mg a day for one month, is recommended, following which the dose is tapered according to the symptoms, not the sedimentation rate.
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PMID:Polymyalgia rheumatica and giant cell arteritis. 647 43

A 79-year old female patient with antecedents of headache and fever, was admitted because of fatigue, anorexia, anemia and elevated ESR. After admission she presented with rheumatic polymyalgia and synovial effusion in the knee. A first biopsy of the temporal artery was normal. After dismissing other possible causes a second biopsy of the contralateral temporal artery was bone and confirmed giant cell arteritis. Diagnostic value of a second temporal artery biopsy is discussed and justified by: a) a confirmed diagnosis is necessary for prolonged treatment with corticosteroids, b) if it is decided to treat the rheumatic polymyalgia with lower doses of corticosteroids than for temporal arteritis the certainty that no temporal arteritis is present and c) shortening the hospital stay and lowering the cost and number of diagnostic procedures. The frequency of arthritis and synovial effusion in temporal arteritis are also discussed.
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PMID:[Giant cell arteritis: diagnostic value of a second biopsy of the temporal artery (author's transl)]. 724 67

A woman of 79 years was admitted to our hospital because of headache and high erythrocyte sedimentation rate (ESR). Temporal artery biopsy demonstrated giant cell arteritis and nonsteroidal antiinflammatory drugs were effective. Another woman of 69 years was admitted because of headache, high ESR, and polymyalgia. Temporal arteritis (TA) with polymyalgia rheumatica (PMR) was established in biopsy of the temporal artery, and steroid therapy was effective. In our hospital, a third patient of 81 years was also suffering from TA with PMR, but temporal artery biopsy was not performed. Those three cases were followed for several years after the diagnosis of TA. Two years later, cancer in cervix of uterus was diagnosed in first case, and acute myelogenous leukemia in second case. However, such symptoms were not observed in third case. These findings and recently described reports suggest that the patients with biopsy-proven TA may have an increased risk of developing malignancy.
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PMID:[Occurrence of malignancy in patients with biopsy-proven temporal arteritis]. 755 30

Giant cell arteritis commonly presents with headache, polymyalgia, and visual signs and symptoms. Other neurological, respiratory or vascular symptoms occur in 10-30% of patients. It is extremely rare for giant cell arteritis to present initially with haematuria. Here we describe a case which presented with fever and haematuria, which emphasise the need to be vigilant about the diagnosis of giant cell arteritis as an underlying cause.
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PMID:Giant cell arteritis presenting as renal vasculitis. 964 Apr 45

We present a case of polymyalgia-like syndrome in a 62-years-old woman with four month history of severe headache, muscular claudication, asthenia, normochromic, normocytic anaemia and elevation of erytrocyte sedimentation rate. A diagnosis of giant left atrial myxoma was made brought about by thoracoabdominal magnetic resonance. Their surgical exeresis was followed by gradual disappearance of symptoms and normalization of laboratory parameters.
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PMID:[Polymyalgia syndrome and atrial myxoma]. 971 Sep 88

Cranial arteritis (CA), also called giant cell arteritis or temporal arteritis, is a vasculitis primarily affecting adults over age 50. It is a large vessel vasculitis, and giant cells classically can be identified on histopathologic examination of temporal arteries, but are not essential for diagnosis. Patients typically present with severe headaches, fatigue, polymyalgia-like symptoms, or ischemic complaints such as jaw claudication. Visual loss is the major feared irreversible outcome and can occur in up to 50% of those with untreated disease. Glucocorticoids, typically high dose prednisone (> or = 60 mg/d) is the first-line treatment and successfully controls the inflammatory disease in the vast majority of patients. Most patients can be tapered off steroids within 6 months to 2 years.
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PMID:Inflammatory disease in older adults. Cranial arteritis. 1566 19


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