Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

Neutrophilic leucocytosis is frequent in systemic diseases and often leads to confusion with infective diseases. A C-reactive protein (CRP) level of 100 mg/l or more has been claimed to indicate a bacterial infection in over 80% of the cases. The purpose of this study was to test the discriminative value of CRP in patients with neutrophilic leucocytosis of bacterial or systemic origin. Sixty patients presenting with an inflammatory syndrome with neutrophilia entered the study and were divided into 2 groups. Group I comprised 30 patients with Horton's disease (n = 9), systemic vasculitis (n = 6), deep cancer (n = 5), connective tissue disease (n = 4) or Still's disease (n = 4). Group II consisted on 30 patients with infective diseases: septicaemia (n = 13), bacterial pneumonia (n = 12), pyelonephritis (n = 4) or cholecystitis (n = 1). In both groups the number of neutrophils was higher than 12,000/cubic mm. Mean CRP values were lower in group I (75.3 +/- 70 mg/l) than in group II (153 +/- 61 mg/l) (P less than 0.01). With values above 100 mg/l the specificity and sensitivity of CRP for infection were 45% and 55% respectively; the positive predictive value of CRP was 66% and its negative predictive value 76%. Specificity rose to 65% with a CRP level higher than 150 mg/l, and 74% for a CRP level higher than 200 mg/l, but such values were also observed in 4 patients of group I.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Neutrophilic leukocytosis of systemic or bacterial origin: discriminative C-reactive protein?]. 209 33