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)

The aim of this investigation was to correlate the clinical and histological findings in 85 consecutive patients with temporal arteritis. Particular attention was given to a possible correlation between optic nerve involvement and the presence of giant cells upon histological examination. Severe ischemia as in anterior ischemic optic neuropathy and central retinal arterial occlusion was presented in 37 patients (43%). Giant cells were definitely observed in 32 biopsy specimens (37.6%) and suspected in 11 additional specimens (13%): In 42 specimens (49.3%) no giant cells were present. Our study showed no correlation between the occurrence of severe optic nerve involvement and the histological findings with regard to giant cells. Statistical evaluation also failed to show a significant correlation between the frequency of pain and jaw claudication and the respective histological findings regarding giant cells. In the biopsy specimen of one patient, numerous eosinophilic granulocytes had infiltrated the vessel wall.
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PMID:Temporal arteritis. Comparison of histological and clinical findings. 797 62

Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are common diseases in the elderly. The arteritis usually affects medium sized vessels, but large vessel involvement can also occur leading to arm claudication, bruits, loss of pulses and pallor of the upper extremities. The differential diagnosis of large vessel arteritis includes atherosclerosis and Takayasu's disease. Atherosclerosis, which affects patients of similar age to GCA is usually confined to the lower limbs and can be differentiated on the basis of the clinical setting and investigations such as the ESR, arteriography and temporal artery biopsy. Takayasu's arteritis' although histologically and arteriographically indistinguishable from GCA, is predominantly a disease of young women. A patient is described who presented with upper limb ischemia. A clinical examination revealed absence of right radial pulses and presence of murmurs at level of the carotids. The blood pressure was unrecordable in the upper right limb. The ESR was 102 mm/hr and the C-reactive protein was 11.66 mg/dl. A selective arteriography of the aortic arch and its branches revealed a right subclavian artery obstruction with good collateral circulation and a left subclavian artery stenosis. The biopsy of left temporal artery showed a typical GCA in acute stage. Treatment with prednisolone 30 mg/day was started and four weeks later, the ESR had fallen to normal. In addition this case confirms that PMR implies a systemic arteritis.
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PMID:[Giant cell arteritis and polymyalgia rheumatica presenting as subclavian artery obstruction]. 823 15

Three patients with visual loss and normal fundi were discovered to have choroidal ischemia on fluorescein angiography. Each patient had a markedly increased Westergren erythrocyte sedimentation rate, but only one described symptoms of polymyalgia rheumatica, neck pain, and jaw claudication. Biopsy of the temporal artery confirmed giant cell arteritis in the two patients without constitutional symptoms. In one patient, typical anterior ischemic optic neuropathy developed the following day, whereas in the other two, anterior ischemic optic neuropathy later occurred despite the prompt administration of intravenous high-dose corticosteroids. Choroidal ischemia may be the first sign of giant cell arteritis in elderly patients with visual loss. Early diagnosis and treatment are mandatory in an attempt to forestall the development of anterior or posterior ischemic optic neuropathy, or central retinal artery occlusion in the affected or fellow eye.
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PMID:Visual loss caused by choroidal ischemia preceding anterior ischemic optic neuropathy in giant cell arteritis. 829 97

A 68-year-old man had visual loss secondary to isolated choroidal nonperfusion as a clinical manifestation of giant cell arteritis. Ophthalmoscopy disclosed scattered yellow-white lesions at the level of the retinal pigment epithelium in the posterior pole of the right eye. Intravenous fluorescein angiography demonstrated marked delay in choroidal filling of the macula in the right eye. There was no ophthalmoscopic or angiographic evidence of anterior ischemic optic neuropathy or central retinal artery occlusion. After approximately 72 hours of intravenous corticosteroid therapy, the patient's visual acuity improved and repeat intravenous fluorescein angiography showed normal choroidal circulation. Isolated choroidal ischemia is a potential cause of reversible visual loss in patients with giant cell arteritis.
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PMID:Choroidal nonperfusion in giant cell arteritis. 835 1

We report a case of Temporal Arteritis, carrier of IgG anticardiolipin antibodies, who presented seronegative polyarthritis with AR criteria after 7 months. Three months later he developed acute ischemia in the right leg, which induced to amputate it. The biopsy showed thrombosis of the femoral arteria, and a dense lymphoplasmocytic infiltrate in its wall. We underline this association (TA-RA) with anticardiolipin antibodies, the exceptional affectation of the femoral arteries in this disease and the probable participation of anticardiolipin antibodies in the genesis of the arterial thrombosis.
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PMID:[Acute ischemia of the lower limb in a patient with temporal arteritis and rheumatoid arthritis, carrier of anticardiolipin antibodies]. 851 39

A 61-year-old man developed fever and a urinary tract infection followed five days later by acute visual loss in the right eye. Funduscopic examination was normal. A retrobulbar optic neuropathy was diagnosed but careful consideration was given to choroidal ischemia as an etiology. A sphenoidal mucocele was found on emergent MRI scan and drained expeditiously, with marked improvement in visual function. The diagnosis of giant cell arteritis should always be entertained when dealing with visual loss in the elderly.
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PMID:Acute unilateral visual loss in the elderly due to retrobulbar optic neuropathy. 897 Feb 41

Horton giant cell arteritis of the legs is a very rare and unusual occurrence. A very interesting case of acute ischemia of the right leg in a 51-year-old woman treated with emergency thromboendarterectomy is described. Histological findings led to the diagnosis of Horton giant cell arteritis and the patient was submitted to steroid and vascular therapy. Good results were obtained and follow-up after five years confirms the good general condition of the patient.
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PMID:Horton giant cell arteritis of the legs. Report of a case. 921 84

Anterior ischemic optic neuropathy (AION), one of the most prevalent and visually crippling diseases in the middle-aged and elderly, potentially bilateral, is due to acute ischemia of the optic nerve head. For a logical understanding of its pathogenesis, underlying causes, clinical features, and management, it is essential to comprehend the basic scientific issues involved; these are discussed briefly in this paper. Clinically, AION is of two types: (1) arteritic AION (due to giant cell arteritis) and (2) nonarteritic AION (due to other causes). Arteritic AION is an ophthalmic emergency because of its potential of causing rapid, bilateral complete blindness which is almost always preventable if treated immediately with large doses of systemic corticosteroids. Clinical parameters which help to differentiate the two type of AION, and their management are discussed.
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PMID:Anterior ischemic optic neuropathy. 929 52

Giant cell arteritis is an inflammatory disease that can affect the arteries anywhere in the body. Two cases are reported in which the arteries of the lower limbs were involved. Intermittent claudication with a walking distance of only 30 m was the inaugural manifestation in both cases. A biopsy of the superficial femoral artery provided the diagnosis in the first case. Ergotamine toxicity was considered initially in the second case. Acute ischemia and gangrene requiring amputation can complicate giant cell arteritis of the lower limbs and consequently corticosteroid therapy in an effective dose should be given as soon as the diagnosis is made. The inflammatory arterial lesions improve under therapy, but irreversible fibrosis with stenosis can develop if treatment is initiated late.
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PMID:Giant cell arteritis involving the lower limbs. 933 33

Molecular studies of giant cell arteritis indicate that T cells are recruited to the wall of medium-sized and large arteries, are activated locally, produce IL-2 and IFN-gamma, and regulate the activity of tissue-infiltrating macrophages. Downstream effects of T cell activation include the production of proinflammatory cytokines, metalloproteinases, and growth factors. Growth factors are instrumental in the process of intimal hyperplasia, leading to luminal occlusion and tissue ischemia. The amounts of IL-2, IFN-gamma, and the growth factor PDGF in the vascular lesions varies among patients and are correlated with differences in patterns of clinical manifestations. Giant cell arteritis complicated by cranial ischemia, such as anterior optic neuropathy or stroke, is characterized by high levels of IFN-gamma and PDGF. If the IFN-gamma-PDGF loop is less developed, fever and wasting can dominate the disease. Dominant production of IL-2 is associated with polymyalgia rheumatica. The finding of different inflammatory pathways translating into different clinical phenotypes may reflect differences in the contribution of the arterial wall. Alternative hypotheses include a role of multiple disease-inducing antigens with different tissue distributions or tropisms.
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PMID:Giant cell arteritis--a molecular approach to the multiple facets of the syndrome. 992 95


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