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)

Extracranial giant cell arteritis occurs in 10% to 15% of patients with temporal arteritis and polymyalgia rheumatica. Aorta and its major branches are most often involved and death may result from an unsuspected ruptured aortic aneurysm or aortic dissection. Involvement of coronary arteries by giant cell arteritis resulting in death from myocardial infarction is extremely rare. This article describes one such case: an 84-year-old man who died of acute myocardial infarction with the unexpected autopsy finding of giant cell aortitis and coronary arteritis, and who, three years earlier, had sudden onset of bilateral blindness and biopsy-proven temporal arteritis.
 ...
PMID:Temporal arteritis with giant cell aortitis, coronary arteritis, and myocardial infarction. 375 98

Giant-cell or temporal arteritis is a generalized vasculitis that predominantly affects large- and medium-sized arteries in people over 50 years of age. The illness is commonly characterized by the initial symptoms of headache, temporal artery tenderness or pulselessness, musculoskeletal pain, fever, and fatigue. The most dreaded consequence of giant-cell arteritis is visual loss, which is usually irreversible on presentation. Giant-cell arteritis may present with unusual clinical manifestations such as lip, scalp, and tongue necrosis, carpal tunnel syndrome, claudication of the limbs, strokes, angina pectoris, myocardial infarction, hematuria, cough, or other CNS symptoms. The etiology of the disease is unknown. Emergency physicians are usually familiar with the more common clinical symptoms but one must consider the unusual manifestations of the disease, because early recognition and initiation of therapy (steroids) decrease morbidity and can prevent blindness.
 ...
PMID:Giant-cell arteritis. 379 80

A patient presented with headache, soreness over her scalp and general malaise. She was treated for hypertension, but later went blind in one eye. Following referral to the Eye Department, she was treated successfully for six episodes of blindness in her second eye. The case highlights the ways in which temporal arteritis may present. Prompt treatment will save vision, but a missed diagnosis may result in blindness.
 ...
PMID:Headache and temporal arteritis. 398 21

Polymyalgia rheumatica, next to rheumatoid arthritis the most common inflammatory rheumatic disorder of the elderly, is a nonspecific clinical syndrome involving pain in the shoulder and pelvic girdles. Giant cell arteritis appears to localize in elastin-containing arteries and can cause similar myalgias. A relationship exists between the two diseases, as evidenced by their frequent coexistence in the same patient. The symptoms of polymyalgia rheumatica respond to low-dose corticosteroid therapy, while giant cell arteritis requires higher doses to prevent blindness due to involvement of the temporal artery. The key decision in therapy, therefore, concerns the dose and duration of use of steroid for polymyalgic symptoms. In this decision, prevention of the catastrophic complications of giant cell arteritis and avoidance of needless side effects of high-dose steroid therapy in the elderly are competing considerations.
 ...
PMID:Polymyalgia rheumatica and giant cell arteritis. The dilemma of therapy. 400 Oct 42

The clinical and laboratory data recorded during a several month study of 90 patients with polymyalgia rheumatica are presented. Especially with elderly women who lack other symptoms it should be borne in mind that muscular and articular pain in the scapular and pelvic regions together with an excessive increase in the blood sedimentation rate--more than 100 mm during the first hour are frequent--may indicate this disease. It is often accompanied by an arteritis of the temporal vessels (giant cell arteritis), which increases the danger of uni- or bilateral loss of sight. In our case material unilateral loss of sight occurred in 3% of the patients, bilateral loss of sight was not observed. A general disturbance in the patients well-being, occasional attacks of fever, non-specific signs of inflammation in the haematological findings and symptomatic anaemia mask the clinical picture and make diagnosis difficult. Initial high doses of cortisonoid and following long-term therapy make all signs and symptoms disappear. The disease can last for several years. The prognosis is favourable. The cause is still unknown.
 ...
PMID:[Polymyalgia rheumatica--clinical observations on 90 patients]. 408 88

We suggest that polymyalgia rheumatica with giant cell arteritis (PR-GCA) is an arachidonic acid metabolites mediated disease which can be diagnosed more accurately and monitored more precisely for therapeutic benefits by the serial determinations of the major urinary prostaglandin F, serum urinary lysozymes, serum acid phosphatase, and serum angiotensin converting enzyme rather than by the erythrocyte sedimentation rate, and, when necessary by temporal artery biopsy. The pathogenetic role proposed for prostaglandins (PG) and, even more precisely perhaps, the leukotrienes in this disease is consistent with the several published clinical observations that non-steroidal anti-inflammatory drug treatment produces in some cases a therapeutic paradox of symptomatic relief with concurrent, if clinically silent, progression of the arteritis, even to blindness. Furthermore, the impressive response of PR-GCA to low maintenance dose steroid therapy, a clinical conundrum for decades, is rationally explained on the basis of depressed or obstructed PG metabolism early on in the metabolic cascade. These views warrant clinical evaluation, confirmation or correction in whole or in part, and may increase our understanding of PR-GCA.
 ...
PMID:Polymyalgia rheumatica and giant cell arteritis--rational diagnosis and treatment predicated and disordered prostaglandin metabolism. 627 May 20

Temporal arteritis is still often overlooked in 1982 as shown by the diagnostic delay reported in a retrospective review of 33 patients and in the series previously published in the medical literature. Clinical features to be especially kept in mind are the occasional nature of temporal signs, the pathognomonic value of jaw claudication and the existence of signs which may constitute a premonitory syndrome of blindness. The frequent rise in alkaline phosphatase levels is often misleading. In patients over 65 with an unexplained inflammatory syndrome, biopsy of both temporal arteries should be promptly performed, prior to the unpleasant and costly investigations designed to detect an occult carcinoma. Corticosteroids are still the best treatment of giant cell arteritis but the optimal initial dosage remains unknown as no data from randomized trials are available. Symptomatic relapses have been reported up to 10 years (5 years for ocular symptoms) after onset of the disease. Because of this protracted course, which makes adequate follow-up difficult to ensure, recovery rates from different series are at variance. The main side-effects of maintenance corticosteroid therapy in these elderly patients are osteoporosis, which warrants systematic countermeasures, and probably an increased rate of atheromatosis.
 ...
PMID:[Horton's disease: retrospective study of 33 cases and review of the literature]. 630 48

Management strategies for suspected temporal arteritis range from bilateral temporal artery biopsy to empiric corticosteroid therapy. A decision analysis of the clinical situation was constructed, and a sensitivity analysis for varying prevalences of temporal arteritis was used to calculate costs for different management strategies. Conclusions suggested by the analysis include the following: (1) due to the high cost of blindness, suspicion of disease must be low (less than 1.4%) not to biopsy; (2) at high suspicion of disease (greater than 30%), empiric steroids are the cheapest management; (3) when diagnostic procedures are indicated, bilateral biopsy is the cheapest initial diagnostic procedure; and (4) if unilateral biopsy is negative, a second biopsy is always cost effective.
 ...
PMID:Management of suspected temporal arteritis. A decision analysis. 641 28

The paranasal sinuses are a common source of maxillofacial pain. When the sphenoid sinus is involved, 13 different structures can also be affected. The various neuralgias are usually easily recognized by their classic symptoms. Temporal arteritis must be diagnosed early in order to prevent blindness. The temporomandibular joint syndrome remains the most misdiagnosed and misunderstood orofacial pain.
 ...
PMID:Maxillofacial pain. 646 48

In the investigation of six patients with giant cell arteritis and abnormal liver function radionuclide liver scans were found to be abnormal in all. The abnormality may be due to arteritis of hepatic vessels. It is important to recognise that giant cell arteritis may cause liver scan abnormalities. If other pathology is suspected and corticosteroid treatment delayed while further investigations are carried out, patients are at risk of complications such as blindness.
 ...
PMID:Abnormal radionuclide liver scans in giant cell arteritis. 647 16


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