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)

Ischemic optic neuropathy, in its arteritic and idiopathic varieties, presents both diagnostic and therapeutic challenges to the clinician, specifically: the role of temporal artery biopsy in management of giant cell arteritis; the preferred treatment regimen for giant cell arteritis, including decisions to begin tapering therapy and stopping therapy; action to take if major steroid complications arise while the disease is still active; distinguishing anterior ischemic optic neuropathy from idiopathic optic neuritis; whether cerebral arteriography is indicated in the assessment of idiopathic ischemic optic neuropathy; and whether steroid therapy is of any value in the treatment of idiopathic ischemic optic neuropathy.
 ...
PMID:Ischemic optic neuropathy. Still the ophthalmologist's dilemma. 651 99

A 73-year-old woman received systemic corticosteroids for suspected temporal arteritis after blindness developed in the right eye during the previous day. Because a right temporal artery biopsy specimen was reported as normal, a diagnosis of arteriosclerotic ischemic optic neuropathy was made and the corticosteroid therapy was discontinued. Two weeks later the patient rapidly lost vision in her left eye. A left temporal artery biopsy specimen showed granulomatous arteritis adjacent to normal artery (skip area). Deeper sections of the original right temporal artery biopsy specimen also demonstrated a small focus of granulomatous arteritis adjacent to normal artery. In patients with suspected temporal arteritis, numerous step sections of a long segment of temporal artery should be examined; if the results are normal, the contralateral temporal artery should be studied. A nonspecific inflammatory reaction within or adjacent to the artery should alert the pathologist to the possible presence of a nearby focus of granulomatous arteritis.
 ...
PMID:Bilateral blindness in temporal arteritis with skip areas. 683 Apr 89

An acute loss of vision accompanied by signs of optic nerve head ischemia in an elderly patient should alert the examiner to suspect the presence of temporal arteritis until it can be proven otherwise. The patient presented here had ischemic optic neuropathy that was initially thought to be due to temporal arteritis, but eventually was proven to be associated with pronounced atherosclerotic aortic arch disease. The diagnosis was complicated by the severe loss of vision and by an elevated erythrocyte sedimentation rate (ESR). A temporal artery biopsy was normal, and other findings implicated the pronounced diffuse atherosclerosis as the cause of the ischemia of the optic nerve head. Therapy was directed toward the vascular occlusive disease, and involved an aortoinnominate bypass graft.
 ...
PMID:Complicated aortic arch syndrome and ischemic optic neuropathy presenting as giant cell (temporal) arteritis. 703 43

Giant-cell arteritis is a polysymptomatic disease of the elderly. Systemic symptomatology includes headaches, arthralgias, myalgias, tender temporal arteries, jaw claudication, low-grade fever, anemia, anorexia, malaise, and weight loss. Visual loss from anterior ischemic optic neuropathy and diplopia resulting from ischemia of the ocular muscles represents the major ocular manifestations of giant cell arteritis. When the diagnosis is suspected, blood for a sedimentation rate should be drawn, and, if it confirms the clinical impression, high dose prednisone should be started immediately and a temporal artery biopsy performed at a later date. Only by asking the proper questions and suspecting the diagnosis will this preventable form of blindness receive the prompt attention it deserves.
 ...
PMID:Giant-cell arteritis. Signs and symptoms. 715 21

Circulatory disorders of the optic nerve may be classified into acute and chronic lesions as well as into anterior and posterior ones. In general, anterior lesions clinically prevail; they are located around the lamina cribrosa and are pathogenetically explained as a consequence of decreased blood flow in the posterior ciliary arteries as well as in the perilaminar capillaries. The symptoms of the acute anterior lesions are described. The nerve head infarction may be induced by various circulatory disorders such as arteriosclerosis, diabetes, elevated blood pressure, giant cell arteritis or other collagen diseases, but also by others. The particular importance of giant cell arteritis is stressed. The prognosis of acute anterior ischemic optic neuropathy is poor, possibilities of treatment are discussed. The chronic anterior lesion is considered to be caused by an imbalance between intraocular pressure and the perfusion pressure in the posterior ciliary arteries and consequently in the perilaminar capillaries. The clinical signs ('low tension glaucoma') are described, the therapeutic measures, although limited, are outlined. The ischemic lesions of the posterior part of the optic nerve are less well defined. However, theoretical considerations as well as clinical experience suggest that such lesions occasionally occur taking either an acute or a chronic course.
 ...
PMID:Circulatory disorders of the optic nerve. 745 23

Patients with anterior ischemic optic neuropathy due to giant cell arteritis are thought to develop optic disc cupping, resembling that seen in glaucomatous eyes, while such cupping does not seem to occur in nonarteritic anterior ischemic optic neuropathy. However, this remains controversial. We describe a patient with arteritic anterior ischemic optic neuropathy (the clinical diagnosis was confirmed with a biopsy from the temporal artery) who developed disc cupping within 4 months after acute episode. This patient never had elevated intraocular pressure, and prior to the acute event the optic nerve heads had had a normal appearance with a physiologic cup.
 ...
PMID:Optic disc cupping in arteritic anterior ischemic optic neuropathy. 784 52

The clinical, laboratorial perimetric and fluorescein angiographic features of the arteritic type of the anterior ischemic optic neuropathy (A-AION) was studied in 25 patients (40 eyes) in order to characterize the profile of the disease and to allow the differential diagnosis with the non-arteritic anterior ischemic optic neuropathy (NA-AION) and other disorders of the optic nerve. The A-AION occurred in patients 60 to 88 years old (mean 74 years) and was highly predominant in females (64 per cent). Fifteen patients had both eyes involved, either simultaneously or usually within few days or weeks after the initial involvement. Headache and eye pain were the most commonly observed prodromic complaints whereas systemic symptoms of giant cell arteritis (GCA) were seen in all patients. The laboratorial abnormalities most commonly found were high values of reactive C protein, plasmatic fibrinogen and erythrocyte sedimentation rate. In the great majority of the patients visual acuity was severely affected. The optic disc was always abnormal, usually showing a pale edema. In addition to that retinal changes were commonly found. Goldmann perimetry disclosed a wide variety of visual fields abnormalities, the most common of them being inferior altitudinal defects. Fluorescein fundus angiography revealed delayed or absent disc fluorescence, or sectorial or diffuse hypofluorescence or hyperfluorescence of the optic disc. Choroidal filling delay was the most characteristic and frequent angiographic finding in the arteritc type of the disease.
 ...
PMID:[The arteritic type of anterior ischemic optic neuropathy. Study of 25 cases]. 789 8

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.
 ...
PMID:Temporal arteritis. Comparison of histological and clinical findings. 797 62

Giant cell arteritis is a systemic necrotizing vasculitis that often causes profound and irreversible visual loss in elderly individuals. We describe a 47-year-old man with fulminant giant cell arteritis whose clinical picture included severe visual loss and several unusual or previously unreported findings. Aggressive treatment with intravenous corticosteroids resulted in a dramatic improvement in the patient's vision. Although no firm conclusions can be drawn from the outcome in a single case, we believe that, in some patients with arteritic ischemic optic neuropathy, aggressive treatment with intravenous corticosteroids may be associated with a better visual prognosis than treatment by the oral route.
 ...
PMID:Recovery of vision in a 47-year-old man with fulminant giant cell arteritis. 811 39

Temporal arteritis is an insidious disease which, if not recognized and treated with high-dosage oral prednisone or intravenous prednisolone, can result in unilateral or even total blindness due to anterior ischemic optic neuropathy (AION) or closure of the central artery of the retina. Unfortunately, the symptoms and clinical signs of temporal arteritis mimic those of a number of other conditions including angle-closure glaucoma, hypertension, migraine, trigeminal neuralgia, temporomandibular joint syndrome, carotid artery occlusive disease, Foster-Kennedy syndrome, and nonarteritic AION. When a patient complains of a severe pain in the temporal region, along with scalp tenderness and a feeling of malaise or depression--with or without episodes of transient loss of vision--he or she should be referred for a diagnostic work-up which includes an erythrocyte sedimentation rate and a temporal artery biopsy. We present here a review of the recent literature concerning temporal arteritis, followed by a report of an unusual case in which high-dosage prednisone therapy was effective in relieving the patient's symptoms and lowering the sedimentation rate in spite of a negative temporal artery biopsy.
 ...
PMID:Diagnosis and management of temporal arteritis: a review and case report. 823 73


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>