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)

We describe an 18-year-old white male who developed lower extremity ischemia requiring amputation. He presented at 14 with pulmonary infiltrates, hepatosplenomegaly, fever, rash, adenopathy, uveitis, and arthralgias; clinical and laboratory findings were consistent with Mycoplasma pneumoniae infection. Despite adequate treatment with antibiotics, he developed chronic arthralgias and fevers, with rash and pericardial effusion. Criteria for the diagnosis of systemic lupus erythematosus were not met; juvenile rheumatoid arthritis was diagnosed presumptively. Over the subsequent 4 years he developed lymphadenopathy with biopsy-proven nonnecrotizing granulomas, chronic leg ulceration with granulomatous histology, and acute-onset impending gangrene of the left foot. A biopsy of the posterior tibial artery demonstrated giant cell arteritis. Although the histologic features were consistent with Takayasu's arteritis, complete aortic arteriography was normal. Examination of the amputated leg showed multifocal segmental giant cell arteritis. Clinicopathologic features suggested, but were not fully consistent with, juvenile systemic granulomatosis. His disease may represent a separate sarcoid-like entity in the broad spectrum of vasculitis.
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PMID:Giant cell vasculitis with extravascular granulomas in an adolescent. 205 10

The authors recently observed 2 elderly female patients with ischemic pain of the upper extremity as the first manifestation of giant cell arteritis. They presented with rest pain of both upper extremities and even gangrene of the thumb in 1 case. Subclavian and radial pulses were absent while peripheral pulses in the lower limbs were preserved. The angiography was so typical that the diagnosis of inflammatory arteritis was made, despite negative temporal artery biopsy. The patient with thumb gangrene was successfully operated on, the occlusive axillary lesions being bypassed by a long venous carotid humeral bypass graft. A biopsy of the axillary artery showed a granulomatous lymphoplasmocellular infiltration. A high-dose corticotherapy (24 mg daily) was begun in both cases, with dramatic improvements of general state, lowering of the erythrocyte sedimentation rate, and even reapparition of a reduced radial pulse in 1 patient. The authors discuss the incidence, symptoms, diagnosis, and treatment of systemic giant cell arteritis, with special attention to extracranial involvement. These case reports may broaden the knowledge of the diverse manifestations of giant cell arteritis and of its systemic character with widespread vascular involvement.
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PMID:Giant cell arteritis (Horton's disease) of the axillary artery--case reports. 265 5

An 80-year-old white man presented with gangrenous lesions involving several distal phalanges of his left hand and an elevated erythrocyte sedimentation rate (ESR). Temporal artery biopsy showed patchy destruction of the internal elastic lamina by mononuclear cell infiltration, consistent with the diagnosis of temporal arteritis. After amputation of gangrenous lesions, he was discharged taking prednisone (60 mg/day). Twelve months after discharge there was no recurrence of ischemic manifestations and ESR was normal. Association of digital gangrene and elevated ESR should alert the clinician toward this diagnosis once other diseases such as atherosclerosis, scleroderma, lupus erythematosus, periarteritis nodosa have been ruled out.
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PMID:Temporal arteritis revealed by upper limb gangrene. 271 2

Giant cell arteritis rarely presents as clinically advanced extra-ocular ischemia or gangrene. Clinically isolated leg involvement with amputation is even more unusual. A 69-year-old woman is described who had giant cell arteritis necessitating bilateral leg amputations. No other clinical sequelae have ensued during a four-year follow-up period. Temporal artery biopsy subsequent to the amputations revealed no arteritis. Disparities between the usual patterns of clinical and anatomic involvement in giant cell arteritis underlie the potential diagnostic difficulties in this disease. Although typically diagnostic, temporal artery biopsy does not always bridge the clinical and anatomic disparities.
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PMID:Giant cell arteritis of the legs. Clinical isolation of severe disease with gangrene and amputations. 376 4

Giant cell arteritis is a systemic disease usually occurring in patients in the fifth decade or older, more often in women. Dermatologic manifestations are rare but, when found, are usually expressed as scalp ulcerations or blanching associated with gangrene of the tongue. The dermatologist should be familiar with the entity because it is often more severe when associated with scalp necrosis, and prompt intervention with corticosteroids can prevent catastrophic sequelae.
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PMID:Giant cell arteritis: a systemic disease with rare cutaneous manifestations. 709 71

We report the case of a patient with extensive extracranial arteritis in whom intermittent claudication of the tongue was followed by incipient gangrene and in whom response to steroid and anticoagulant therapy was rapid. The importance of recognizing this unusual presentation of temporal arteritis and instituting therapy early is emphasized.
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PMID:Acute lingual ischaemia complicating temporal arteries. 725 18

Twenty-five patients with biopsy-proven giant cell arteritis (GCA) were treated at the Royal Adelaide Hospital from 1973 to 1978. Three patients had a normal ESR on presentation. Four patients developed monocular blindness, one had gangrene of the tongue, and one had a brain-stem stroke. Six patients had concurrent autoimmune thyroid disease, one suffered from myasthenia gravis and one had ulcerative colitis--a significant observation in view of the suggestion that GCA has an immunological basis.
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PMID:Giant cell arteritis. A five-year review of biopsy-proven cases in a teaching hospital. 739 75

This case report documents gangrene of the small intestine caused by giant cell arteritis of the regional mesenteric arteries, as an uncommon presentation of generalized giant cell arteritis. The literature concerning similar cases and the etiology is discussed.
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PMID:Giant cell arteritis with small bowel infarction. A case report and review of the literature. 739 42

A case of a patient with headache, visual deficiency in his left eye quickly worsening up to blindness and ischemic necrosis in the scalp regions supplied by the superficial temporal arteries, is reported. This acute gangrene began as a bandlike ischemic lesion in the temporo-parietal regions of both sides, rapidly enlarged, and acquired bizarre irregular outlines. Laboratory investigations and particularly superficial temporal artery biopsy confirmed the diagnosis of Horton's temporal arteritis, in accordance with the anamnestic and clinical data assessed at admission.
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PMID:[Multiple gangrenous lesions of the scalp in a case of cranial arteritis]. 756 55

Giant cell arteritis (GCA) is a systemic disease of the elderly that occurs infrequently in blacks and seldom has peripheral vascular disease and stroke as its presenting major complications. The occurrence of bilateral lower limb gangrene and a fatal stroke as manifestations of occult systemic GCA in an African-American is such a unique combination of rare occurrences that it warrants documentation in the literature.
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PMID:Bilateral lower limb gangrene and stroke as initial manifestations of systemic giant cell arteritis in an African-American. 773 67


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