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)

Three women of 66, 68 and 69 years of age presented with chronic arm claudication caused by giant cell arteritic stenoses and occlusions of their arm arteries. In the early stage of the disease, arteriography revealed smooth or undulatory long-segment narrowings. Subsequently, spindle-shaped filiform stenoses developed. They were unilateral in one patient, bilateral-symmetric in another and like a string of beads in the third. In the end, untreated arteritis resulted in smoothly tapered occlusions of the diseased vessels. In patients with symptoms and signs suggestive of giant cell arteritis, typical arteriographic findings may confirm the diagnosis even if histopathological proof is lacking.
 ...
PMID:[Angiographic diagnosis in giant cell arteritis of the arm arteries]. 145 95

A 69-year-old woman presented with bilateral arm claudication caused by segmental occlusions of both brachial arteries. Bilateral retrograde ring-desobliteration resulted in restauration of full pulses. Microscopic examination of the resected specimen revealed giant cell arteritis. No other manifestations of the disease could be detected. At autopsy affection of the aortic arch and of the arm arteries is found in about 70% of patients with giant cell arterities. Symptoms occur in only about 5% of them. Arterial stenoses are successfully treated with corticosteroids. In case of chronic occlusion, however, ischemia-induced symptoms may necessitate an operation. Endarterectomy (i.e. total dissection of the destroyed inner arterial wall layers) should be preferred to bypass procedures. Subsequent long-term corticosteroid therapy should be instituted in order to treat the underlying disease, and to prevent reocclusions.
 ...
PMID:[Bilateral brachial claudication as the initial manifestation of giant cell arteritis. Case report and review of the literature]. 148 78

In a series of 60 patients with Wegener's granulomatosis, 2 had initially presented with clinical signs suggestive of temporal arteritis. One of these two patients was a 69-year old woman suffering from inflammatory pain in the shoulders, wrists and knees, myalgias in the lower limbs and intermittent jaw claudication. The other patient was a 60-year old man with febrile polyarthritis predominantly affecting the knees and shoulders, and hyperaesthesia of the scalp. In both cases biopsy of the temporal artery gave negative results. Corticosteroids provided a dramatic improvement, but a relapse corrected the diagnosis. Three similar cases have been reported, but only one had a histological lesion of the temporal artery. Cases of temporal arteritis associated with pulmonary granulomatosis raise the problem of classification with localized Wegener's disease. An initial presentation suggestive of temporal arteritis may hide other systemic diseases, notably rheumatoid arthritis, periarteritis nodosa or Chug and Strauss angitis; Wegener's granulomatosis must be added to this list.
 ...
PMID:[Wegener's granulomatosis disclosed by clinical symptoms of Horton's disease]. 177 20

Upper limb claudication and pulselessness is an uncommon presentation of giant cell arteritis (GCA), often resulting in delayed diagnosis. We describe such a case diagnosed by angiography, in which a temporal artery biopsy showed classic GCA, despite the absence of local signs or symptoms. A review of 26 similar cases revealed that in 81% of patients where the only manifestation of GCA was upper limb findings, temporal artery biopsy yielded positive findings. Steroid therapy clinically improved 24/26 patients. These findings suggest that a consideration of temporal artery biopsy early in the investigation will hasten diagnosis and appropriate therapy.
 ...
PMID:Giant cell arteritis presenting as limb claudication. Report and review of the literature. 185 19

Polymyalgia rheumatica and temporal arteritis are separate but overlapping rheumatic diseases commonly seen among elderly persons. Polymyalgia rheumatica is characterized by upper body and trunk myalgias/arthralgias and an elevation in erythrocyte sedimentation rate. In about half of patients, temporal arteritis begins after polymyalgia rheumatica. Temporal arteritis is a systemic granulomatous disease that predominantly affects branches of the carotid artery. Claudication of the muscles of mastication and a painful burning tongue may develop during temporal arteritis or be the initial presenting symptoms. Recognition that these orofacial manifestations may be part of the disease process is mandatory because one third of patients with untreated temporal arteritis may go blind.
 ...
PMID:Polymyalgia rheumatica and temporal arteritis. 213 75

A variety of rheumatologic disorders affect the elderly. Some of these problems are seen almost exclusively in the elderly, such as temporal arteritis and pseudogout. Because of underlying chronic diseases, these patients are also at increased risk for joint infection and resultant sepsis. Evaluation of synovial fluid from the inflamed joint is important. Light microscopy evaluation with a red polarizing compensator can help diagnose crystal-mediated disease, such as gout or pseudogout. Examination of Gram stains can help diagnose infectious arthritis. Thus, appropriate processing of synovial fluid is mandatory for the diagnosis of many rheumatologic disorders that occur in the elderly. A variety of metabolic disorders are associated with pseudogout and should be searched for on laboratory evaluation. Appropriate laboratory evaluation and follow-up following the acute episode are important in the care of these patients. For example, temporal arteritis with resultant blindness is a feared disorder in the elderly. Transient blindness, headaches, jaw claudication, and an elevated Westergren sedimentation rate suggest this diagnosis. Aches and pain in the neck and shoulder area, especially in the morning, are typical of polymyalgia rheumatica. Polymyalgia rheumatica may also be a symptom of temporal arteritis.
 ...
PMID:Acute rheumatologic disorders in the elderly. 218 87

Giant cell arteritis is a rare, poorly understood, and often misdiagnosed entity. A case is reported of giant cell arteritis in a 30-year-old white male who developed severe bilateral peripheral claudication affecting both legs. The erythrocyte sedimentation rate (ESR) was markedly elevated. The diagnosis of vasculitis was established by histology postoperatively following exploration of both superficial femoral arteries and the placement of a reversed saphenous vein bypass graft to the right leg. Biopsy of the temporal artery revealed no pathology. The patient has been completely asymptomatic postoperatively and has resumed all previous normal activities. This condition has persisted in spite of a failed graft determined by an arteriogram performed 3 months after surgery. He has been treated with steroids continuously since the procedure.
 ...
PMID:Bilateral superficial femoral giant cell arteritis. 219 69

Though surgeons have little input in the selection of patients for temporal-artery biopsy, a knowledge of temporal-artery anatomy and the pathophysiology of temporal arteritis is important. All temporal-artery biopsies done at Carraway Methodist Medical Center between January 1980 and January 1985 were reviewed. Seventy-three biopsies were performed on 70 patients and eight (11.4%) were found to have temporal arteritis histologically. One patient was judged to have temporal arteritis clinically, despite a negative biopsy of short length. Six of eight patients with positive biopsies were female, with an average age of 71.7 years. The most common signs and symptoms of those patients with positive biopsies were temporal headache (8/8), elevated erythrocyte sedimentation rate (7/8), temporal tenderness (5/8), jaw claudication (3/8), and visual changes (3/8). All biopsies were done under local anesthesia and there were no complications. With increasing awareness of the segmental nature of the disease, the length of biopsy specimens (formalin treated) increased from an average of 0.4 cm in 1980 to 2.4 cm in 1984. During this time, the positive rate increased from 0 per cent (0/9) to 17 per cent (4/24). A generous biopsy of approximately 5 cm in length of fresh vessel is recommended to confirm the suspected diagnosis of temporal arteritis.
 ...
PMID:Temporal artery biopsy. 240 66

Ocular complications occurring in temporal arteritis are of different severities. These manifestations of the disease occurred in a population of 57 patients with diagnosis of temporal arteritis, in 16 of them (28%). The diagnosis was suggested by finding an inflammatory syndrome (high erythrocyte sedimentation rate) and confirmed by temporal artery biopsy. In making this diagnosis, it was helpful to find a history of characteristic temporal headaches, neckache, jaw claudication, fever and malaise or weight loss in addition to polymyalgia and polyarthralgia. 6 patients presented with diplopia and different ocular muscle or nerve palsies. The 10 others came for sudden loss of vision due to ischemic anterior or posterior neuropathy and in one case, central artery obliteration. Prompt treatment with steroids gave good results on oculomotor troubles and in preventing the risk of involvement of the fellow eye. But loss of vision did not regress with this treatment. That means the importance in making this diagnosis and starting very promptly this treatment.
 ...
PMID:[Eye manifestations of Horton's disease]. 259 Sep 88

Stiffness of the jaw was noted in the first descriptions of temporal arteritis. It was only in 1944 that Horton used the term intermittent claudication and related this sign to effort ischemia due to thrombosis of facial arteries. The introduction of ultrasound techniques has enabled the permeability of facial arteries to be confirmed in spite of induration and absence of pulsatility clinically. Anatomical studies have defined the preponderant role of the internal maxillary artery in the vascular supply of the masseter muscles and have enabled the localization of an appropriate and reliable site for ultrasound study: the pterygo-maxillary fossa. The velocimetric data thus collected confirm that the internal maxillary artery is affected and define the etiopathogenesis of intermittent jaw claudication during temporal arteritis. This sign is observed on average in one patient in three suffering from temporal arteritis. While several cases of intermittent jaw claudication have been described in severe atheromatous stenosis of the common carotid or external carotid arteries, or in relation to other causes (rheumatological, neoplastic, psychological ...), the observation of this syndrome in a suspicious clinical and paraclinical context constitutes an excellent orientation sign in favor of temporal arteritis.
 ...
PMID:[Intermittent claudication of the jaw in temporal arteritis]. 269 73


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