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 report the case of an 85-year-old man with perfectly controlled hypertension and coronary insufficiency who presented with typical giant cell arteritis (GCA). Thirty-six hours after initiation of prednisolone therapy (1 mg/kg/d), acute coronary insufficiency with non-transmural infarction occurred. Outcome was favorable despite disturbances in heart rhythm. A review of the literature disclosed five cases of myocardial infarction related to GCA, confirmed upon pathological examination. Three out of five myocardial infarctions occurred between the third and seventh treatment days. These findings suggest that corticosteroids may be responsible for coronary complications which arise during the first days of GCA treatment. Furthermore, they justify close monitoring during the initial phase of treatment in patients with coronary diseases.
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PMID:[Coronary complications of Horton's disease: precipitating role of corticoids?]. 632 27

Precise information was obtained by a computerized analysis of the treatment, prognosis and clinical outcome of 108 representative cases selected from a series of 160 patients with Horton's disease (HD) diagnosed between 1970 and 1981. At the end of the study, 18 patients had died (16,6 p. 100), the commonest cause of death being a cerebrovascular accident. Death occurred during the first two years of the illness in half these cases. Despite these early complications of the disease, from a statistical point of view, the patients did not die of HD or the complications of its treatment. The 5 years survival rate 80,1 p. 100 (actuarial analysis). Most deaths were from natural causes; an intercurrent disease was often implicated; the lower probability of survival for men (69,9 p. cent at 5 years, compared to 85,4 p. cent for women) is compatible with the lower life expectancy which is well established. The roles of intercurrent disease and sex were statistically significant. On the other hand, there was no difference in the probability of 5 year survival when the different presenting of the disease, the terrain (HLA-DR4) and choice of corticosteroid therapy were compared. The initial dose of prednisone or prednisolone should exceed 0,5 mg/kg/day, if relapse is to be avoided. No additional benefits were observed with doses in excess of 1 mg/kg/day except in cases with complications from the onset (ocular, coronary insufficiency, stenosis of the main large arteries, without being able to prejudge their mechanism).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Outcome, treatment and prognosis of Horton's disease]. 665 Oct 63