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)

Elderly patients with persistent unexplained fever require a diagnostic evaluation that focuses on specific infections (eg, occult abdominal abscess, bacterial endocarditis, miliary tuberculosis), rheumatic disorders (eg, temporal arteritis, polyarteritis nodosa), and neoplasms (eg, lymphoma, nephroma). Assessment is directed by the subtle clues elicited from meticulous, repeated history taking and physical examination. Therapeutic trials or exploratory laparotomy may be appropriate but should not be attempted out of a sense of frustration.
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PMID:Fever of unknown origin in the elderly. A sequential approach to diagnosis. 140 72

Primary care physicians have often to provide care to elderly patients presenting with non specific general complaints such as anorexia, weight loss and fatigue associated with biological inflammatory tests (increased erythrocyte sedimentation rate, increased CRP, anemia of inflammatory origin). In elderly patients, inflammatory diseases of unknown origin are most often related to an infectious illness (particularly bacterial endocarditis or tuberculosis), a systemic autoimmune disorder (temporal arteritis, polymyalgia rheumatica or ANCA positive vasculitis) or a neoplastic process. A methodological clinical approach is discussed and the most valuable complementary tests are proposed.
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PMID:[Clinical approach to inflammatory syndromes in the aged]. 1110 92

We describe a retired physician who presented with visual disturbance and systemic symptoms. The presence of general malaise, headache and scalp tenderness, with raised inflammatory markers, suggested that giant cell arteritis (GCA) was the likely diagnosis. Rapid response to initial steroid therapy and histological evidence of inflammation in the temporal artery supported this diagnosis. The character of these visual symptoms was, however, atypical for GCA. The patient, who had heart valve disease, subsequently deteriorated and developed further symptoms warranting investigation of bacterial endocarditis. Retinal emboli are a recognised complication of endocarditis, which could account for these visual symptoms. Moreover, interpretation of the temporal artery biopsy is limited in the context of existing steroid therapy. Our patient was consequently diagnosed with bacterial endocarditis. This case reminds us to consider the wider differential diagnoses for headache, visual disturbance and systemic symptoms, where echocardiogram and blood cultures may be crucial to reach the diagnosis.
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PMID:Visual disturbance with systemic symptoms: old lessons revisited. 2779 82