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

We report 5 cases of temporal arteritis associated with a diabetes whose good evolution under corticotherapy suggests a common pathogenesis. Several hypotheses can be formulated to explain the origin of the glycemic abnormality and to understand the way corticotherapy is effective. A moderate posology could at first have a hyperplasic effect on the insulin-secreting cells, and later on a favorable action on the vascular lesion and on an immunological disorder. Any definitive conclusion cannot be evolved yet. Only a more systematical study of the glycoregulation's abnormalities in the temporal arteritis will enable to answer the many remaining questions.
 ...
PMID:[Corticosteroid-sensitive chemical diabetes in Horton's disease]. 49 79

Although corticosteroid treatment is clearly beneficial to patients with temporal arteritis, its exact risk/benefit ratio in these old and side effects-prone patients is unknown. We have thus surveyed that available French and English literature, in order to pool the published series and to evaluate the iatrogenic potential of corticosteroids in this situation. We selected 11 series, yielding a total of 1008 patients. A treatment failure resulted in the death of the patient in five cases. Twenty-seven patients became blind, but only 2 under treatment. The side-effects involved 29% of the patients and are responsible of 29 deaths (2.9%): osteoporosis was the main problem, followed by femoral head necrosis and muscle wasting. Gastroduodenal ulcers were uncommon and generally benign; sigmoid colon diverticulitis was infrequent but dangerous; some infectious complications were noted (herpes zoster, tuberculosis, etc...); high blood pressure and diabetes were common problems. Psychiatric side-effects were rare. Thus, the unwanted effects of corticosteroids in the treatment of temporal arteritis are relatively infrequent and generally not severe, except osteoporosis. They should be systematically prevented by appropriate diet and treatments (e.g., calcium, potassium, and vitamin D supplements).
 ...
PMID:[Benefits of corticosteroids in the treatment of Horton's disease and rhizomelic pseudopolyarthritis: advantages and inconveniences. A meta-analysis]. 134 39

A 62-year-old lady with hypertension and diabetes developed bilateral, sequential ischemic optic neuropathy, progressive in the right eye. Because of a reported association between amiodarone and optic neuropathy with disc edema, the patient discontinued taking this medication; however, her visual loss continued. The differential diagnoses of bilateral ischemic optic neuropathy--including infiltrative optic neuropathy and temporal arteritis--were exhaustively investigated in this patient.
 ...
PMID:Getting to the heart of visual loss: when cardiac medication may be dangerous to the optic nerves. 156 39

The analysed clinico-biological manifestations, evolutive course and treatment of 30 patients with GCA are presented. The most frequent symptoms were fever and headache. 33% of patients had FOD criteria. 26% had various visual alterations. All patients were initially treated with steroids. Of the 26 patients followed up, 21 (81.7%) experienced some sort of complication: Cushing iatrogenic, osteoporosis, vertebrae collapse, aseptic necrosis of the femur head, arterial hypertension, diabetes mellitus, hyperlipidemia, steroid myopathy. 6 patients were treated with cyclophosphamide, following severe complications secondary to steroid therapy, and all of them had a good clinical evolution.
 ...
PMID:[Giant-cell arteritis: the clinico-biological manifestations and the complications secondary to steroid treatment]. 191 67

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.
 ...
PMID:A population-based case-control study of temporal arteritis: evidence for an association between temporal arteritis and degenerative vascular disease? 262 Oct 19

The records of 293 patients admitted to Padua University Eye Clinic with diagnosis of optic neuropathy were reviewed. Age and sex distribution of different types of optic neuropathies were analyzed. 84 patients (28.7%) with a mean age of 61.9 years had anterior ischemic optic neuropathy (AION). The mean follow up of these patients was 3 years. In less than 30% of patients stabilized visual acuity of the first affected eye was better than 20/200; however, patients younger than 65 showed a significantly (p less than 0.01) better visual acuity than patients older than 64. Involvement of the second eye was found in 26 patients with AION (30.9%), of whom only five were considered idiopathic. The latency before controlateral eye involvement was significantly (p less than 0.05) shorter in patients over 64 years of age than in the younger group. Commonly known associated conditions such as giant cell arteritis (3.6%), arterial hypertension (34.5%), diabetes mellitus (10.7%), both arterial hypertension and diabetes (8.3%), migraine (7.2%) or intracapsular cataract extraction (1.2%) were considered. The frequency of a number of risk factors was found out in patients with arterial hypertension and/or diabetes and in patients with idiopathic AION. Symptoms or signs of ischemic cardiopathy and/or peripheral nonarteritic vascular disease, TIAs prior to AION onset, elevated plasma cholesterol or triglyceride levels, excessive smoking were considered. These risk factors were not found in 11.1% of diabetic patients with AION, in 37.9% of hypertensives, in 14.2% of both diabetic and hypertensive patients and in 31% of patients with idiopathic AION. Our data seem to indicate that the onset of AION may be influenced more strongly from these risk factors than aging.
 ...
PMID:Anterior ischemic optic neuropathy and aging. 277 May 22

Eight patients with giant cell arteritis (6 with Horton's disease and 2 with polymyalgia rheumatica) were investigated for abnormalities in glycoregulation, previously reported in Horton's disease, using oral glucose tolerance tests with measurement of insulinaemia and C-peptide response to glucagon to evaluate pancreatic function. The results were compared with those obtained in an age and weight matched population of patients with inflammatory syndromes of other origins. All patients with giant cell arteritis had abnormal glucose tolerance tests, with diabetes mellitus in 6 and impaired glucose tolerance in 2. Insulinaemias at all stages of the test, insulin response areas and basal C-peptide values were elevated; C-peptide response to glucagon was normal. Similar results were observed in patients with other inflammatory syndromes. It is concluded that glycoregulation disorders are not incidental in giant cell arteritis, that the normal pancreatic function seems to exclude immune pancreatic vasculitis, and that the abnormal glycoregulation is probably due to insulin-resistance. Since these abnormalities cannot be explained by the patients' advanced age alone, the part played by the inflammatory syndrome, which was common to both groups, is discussed. Its responsibility for inducing insulin-resistance may account for the fact that corticosteroids, which are rapidly effective against giant cell arteritis, normalise oral glucose tolerance tests.
 ...
PMID:[Glycoregulation disorders in giant-cell arteritis]. 316 17

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.
 ...
PMID:Acute ischemic atrophy of papilla disc and diabetes. 345 15

A prospective study was conducted in 438 patients with anterior ischemic optic neuropathy (AION). There were 388 patients with nonarteritic AION and 50 with arteritic AION. The risk of bilaterality in patients with arteritic AION was found to be 1.9 times the risk in patients with nonarteritic AION (P = 0.0118). The cumulative incidence curve, considering the time taken to develop bilateral AION for nonarteritic cases was significantly (P = 0.0103) different from that for arteritic cases. The estimated 25th-percentile time to development of bilateral AION was much shorter in patients with arteritic AION (0.4 month) than in those with nonarteritic AION (32.4 months). In arteritic AION, unilateral as well as bilateral AION had almost invariably developed before systemic steroid therapy was started and not after, indicating that this therapy is effective in preventing the development of AION in giant cell arteritis. In nonarteritic AION, the risk of bilaterality was significantly greater in men (P = 0.0113) and in young (less than 45 years old) patients with diabetes (P = 0.0245), with no significant difference attributable to the other age groups or other associated systemic diseases. In this study, it was found that young diabetic men have a risk of AION developing in the second eye that is 1.56 times the risk in young diabetic women, 2.56 times the risk in women who either are nondiabetic or are not young, and 1.64 times the risk in both older men and nondiabetic men.
 ...
PMID:Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors. 365 62

A series of 24 consecutive patients presenting with a fundus picture characterized by a predominance of cotton-wool spots, or a single cotton-wool spot, is reported. Excluded were patients with known diabetes mellitus. Etiologic conditions found included previously undiagnosed diabetes mellitus in five patients, systemic hypertension in five patients, cardiac valvular disease in two patients, radiation retinopathy in two patients, and severe carotid artery obstruction in two patients. Dermatomyositis, systemic lupus erythematosus, polyarteritis nodosa, leukemia, AIDS, Purtscher's retinopathy, metastatic carcinoma, intravenous drug abuse, partial central retinal artery obstruction, and giant cell arteritis were each found in one patient. In only one patient did a systemic workup fail to reveal an underlying cause. The presence of even one cotton-wool spot in an otherwise normal fundus necessitates an investigation to ascertain systemic etiologic factors.
 ...
PMID:Cotton-wool spots. 386 24


1 2 3 4 5 Next >>