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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Angiograms of 10 patients with giant cell arteritis who had large-artery and aortic abnormalities were reviewed. The affected arteries had multiple stenotic areas, and occlusions were relatively common, usually located at the end of tapered stenotic segments. Bridging collateral arteries usually refilled the distal portion of the occluded artery. The laterations were seen most frequently in the subclavian, axillary, and brachial arters, and the arteriographic lesions reflected the clinical findings. Such arteriographic abnormalities are suggestive of giant cell arteritis in a patient over the age of 50. The differential diagnosis includes Takayasu's disease, arteriosclerosis, thoracic outlet syndrome, and ergotism.
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PMID:Extracranial angiographic findings in giant cell (temporal) arteritis. 1 99

Nineteen patients with polymyalgia rheumatica and/or temporal arteritis were classified by degree of clinical and arteriographic abnormality, biopsy grade of arteriosclerosis, and giant cell arteritis (GCA). Temporal arteriograms were very sensitive in detecting abnormal arteries. However, the assumption of some previous studies, that certain angiographic abnormalities are synonymous with GCA, was not supported, since biopsies from distal sites in a Class I and a Class II arteriogram revealed only arteriosclerosis. Class III arteriograms correlated with proximal biopsies of GCA. Immunofluorescent staining was negative in all cases.
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PMID:Temporal arteriography and immunofluorescence as diagnostic tools in temporal arteritis. 32 79

Two elderly patients presented with symptoms suggestive of occult temporal arteritis. Both were treated with high doses of corticosteroids although subsequent biopsies of the arteries did not show evidence of arteritis. After 5 months of corticosteroid therapy, the first patient died of Gram-negative bacterial pneumonia and cystitis and disseminated intravascular coagulation. The second patient, six days after the biopsy, died of pneumococcal meningitis which had presumably spread from a focus about the left optic nerve. In the first patient, necropsy studies showed that the loss of vision appeared to be due to arteriosclerosis of the nutrient vessels of the optic nerve while in the second patient, the visual symptoms appeared to be due to a localized optic perineuritis. Corticosteroid therapy in elderly patients carries a high morbidity, as is illustrated by the first case and may mask unsuspected underlying disease processes, as presumably occurred in the second. We discuss the importance of obtaining a biopsy diagnostic of temporal arteritis in order to justify the continuation of corticosteroid therapy and the significance of a negative biopsy.
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PMID:Complications of corticosteroid therapy in presumptive temporal arteritis. 107 27

Besides the true ischaemias of the optic nerve, which explain the post-haemorrhagic amaurosis, the low tension glaucoma and the open angle glaucoma, there are two varieties of vascular pseudopapillitis. First the variety due to arteriosclerosis, which is characterized by a palid oedema of the disc, followed by optic atrophy, a diminution of the vision field, as well as by signs of arteriosclerosis at the biopsy of the temporal artery. The second variety is the temporal arteritis, which is also characterized by a palid oedema of the disc, followed by optic atrophy, a visual loss, which is often complete, a marked rise of the erythrocyte sedimentation rate and a typical granulomatous arteritis at the biopsy of the temporal artery. These two varieties are due to an involvement either of the short posterior ciliary arteries or of the central vascular or pial system of the optic nerve.
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PMID:[Vascular pseudopapillitis (author's transl)]. 120 56

Indirect immunoperoxidase staining for fibrinogen/fibrin and fibronectin was performed on normal and healing arterial tissue of muscular and smaller elastic arteries. Fibronectin was observed in the wall of the normal arteries, whereas fibrinogen/fibrin could not be demonstrated. Fibronectin was observed in the intima as well as the media deposited in a similar fashion in the femoral and carotid artery during repair. Apart from the early occurrence of fibrin/fibrinogen in the media of both arteries the distribution of fibrinogen/fibrin and degradation products differed. In the femoral artery a progressively weakening positive reaction for fibrinogen/fibrin and degradation products towards the lumen was observed in the intima and the media 7 and 14 days after the lesion. By 28 days the reaction in the media was negative. No thrombus formation was observed. In contrast, all the specimens examined from the common carotid arteries were obliterated by luminal thrombi 28 days after the lesion. The thrombus as well as the damaged intimal thickening and the compressed media were loaded with fibrinogen/fibrin and degradation products. The deposition of fibronectin, fibrinogen, and degradation products in the carotid artery was similar to that previously reported in experimental aortic arteriosclerosis in rabbits as well as in giant cell arteritis.
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PMID:Injury and repair of smaller muscular and elastic arteries. Immunohistochemical demonstration of fibronectin and fibrinogen/fibrin and their degradation products in rabbit femoral and common carotid arteries following a dilatation injury. 250 16

The first population-based incident case-control study of temporal arteritis (TA) in the US was conducted using the unique data resources of the Rochester Epidemiology Project. During the period 1950-1985, 88 newly diagnosed cases of biopsy-proven TA were identified among residents of Olmsted County, Minnesota. Cases were each matched to four Olmsted County community controls on age, sex and duration of community medical record. Odds ratios (OR) were calculated for marital status, education, Quetelet index, pregnancy, age at menopause, thyroid disease, diabetes, smoking, hypertension, angina, myocardial infarction, peripheral vascular disease, and stroke. Multivariable conditional logistic regression analysis identified statistically significant adjusted OR for smoking (2.3, 95% CI = 1.3-4.1). Elevated ORs which were not statistically significant were noted for angina, myocardial infarction, and peripheral vascular disease. These data suggest that TA and arteriosclerosis may share a common causal pathway. Alternatively, histopathological misclassification of temporal artery biopsies may have resulted in the observed association. Due to the limited power of this population-based study, multicentre collaboration should be encouraged to more precisely define the epidemiology of TA.
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PMID:A population-based case-control study of temporal arteritis: evidence for an association between temporal arteritis and degenerative vascular disease? 262 Oct 19

Acute ischemic neuropathy is the acute ischemic necrosis of the optic nerve fibers occurred by the occlusion of small vessels which distribute widely to lamina cribrosa and anterior et posterior area of lamina cribrosa. Pale coloured edema and light swelling are seen generally on the optic disc, and after a few months falls in simplex nerve atrophy. I have explained my 3 cases of ischemic neuropathies. They have some things in common, and causes are considered arteriosclerosis or temporal arteritis in old people, and often takes place based on diabetes mellitus, lupus erythematosis or another many diseases etiologically.
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PMID:Acute ischemic atrophy of papilla disc and diabetes. 345 15

Clinical and laboratory findings of 237 consecutive patients who had 250 temporal artery biopsies performed at the Wilmer Institute during a 15-year period were reviewed. Biopsies were reviewed independently on three separate occasions by four observers who, unaware of the clinical history, made one of the following histopathologic diagnoses: active arteritis, healed arteritis, arteriosclerosis, atherosclerosis, normal, or other. Biopsies were reviewed a fourth time by the observers together to establish a consensus diagnosis. The frequency of intraobserver disagreement in biopsy interpretation ranged from 4.4 to 25.6% of cases. The frequency with which observers disagreed with the consensus diagnosis (interobserver variation) ranged from 4.3 to 13.5% of cases. Pre-biopsy steroid therapy for seven to eight weeks or longer was associated with loss of the histopathologic features of active arteritis. We recommend biopsies for all patients with known contraindications to steroid therapy. In addition, multivariant regression analysis suggests that certain patients can be selected who are likely to have positive biopsies. For some patients, the clinical diagnosis of temporal arteritis can be based on the clinical signs and symptoms and their response to a therapeutic trial of steroids.
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PMID:Temporal arteritis. A clinicopathologic study. 370 28

Posterior acute ischemic neuropathy is a new and distinct clinical entity. This syndrome associate unilateral visual disturbance with arcuate or altitudinal defect. Ocular ophthalmoscopic examination and fluorescein fundus angiography are normal at the onset of the disease. Later develop varied degrees of optic atrophy. Association with anterior optic acute ischemic neuropathy on the other eye is possible. Systemic lupus erythematosus, periarteritis nodosa, temporal arteritis, and arteriosclerosis are often involved. Study of three personal cases. Discussion on pathogenesis.
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PMID:[Posterior acute ischemic optic neuropathy (author's transl)]. 612 69

Temporal arteritis is a systmic disease with a predilecation for the cranio-temporal vascular area. Histologically it is a panarteritis. Diagnosis is based on the presence of lymphocytes, histiocytes and foci of epitheloid cells in the media of the temporal artery. The presence of giant cells is, however not obligatory. The present study emphasizes the value of biopsy of the temporal artery in diagnosing this disease. It, furthermore, also points out the 10-percent possibility of false negative biopsy results based on patchy vascular lesions. Tenderness to touch of the temporal artery, characteristic of temporal arteriitis, can be explained by perineural inflammatory infiltration of nerves in the adventitia of this artery. Examination under the electron microscope reveals almost complete destruction of the smooth muscles of the media by epitheloid cell granulomas. Massive neogenesis of collagen ensues. Furthermore, numerous myofibroblasts, macrophages and histiocytes are observed. Several macrophages close to each other create the impression of giant cells in the light microscope. The electron microscope image allows for clear differentiation between temporal arteritis on one hand and of arteriosclerosis on the other. Using the immunoperoxidase method in temporal arteritis, immune globulines are found intracellularly in plasma cells. Extracellularly, however, neither immune golbulins nor complement deposits are found in the vascular wall. Thus, the assumption that temporal arteritis represents a immune complex disorder cannot be maintained. The most frequent ophthalmologic complication in temporal arteritis is ischemic optic neuropathy. Histologic examination of a bulbus presenting anterior ischemic optic neuropathy in a case of temporal arteritis revealed predominantly lymphocytic infiltrations of the short and long ciliary arteries. No inflammatory infiltration was found in the central retinal artery. The development of anterior ischemic optic neuropathy can be explained by impaired perfusion or by occlusion of the short posterior ciliary arteries. In 60% of patients suffering from temporal arteritis, we found anticollagen antibodies in the serum. Collagenization of the vascular wall as observed in our electron-microscopic examinations must, therefore, be considered the paradoxical consequence of an immune reaction caused by collagen auto-antibodies. Collagen auto-antibodies play a decisive role in the maintenance and chronicity of the inflammatory process in temporal arteritis. In therapy, corticosteroids should not be administered according to rule but rather in doses adjusted to individual requirements.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Electron microscopic and immunohistologic studies of patients with Horton's temporal arteritis]. 638 7


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