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)

Giant cell arteritis, which is probably due to disturbed immune mechanisms, has a spectrum of clinical symptoms in elderly people. In nearly all cases such general signs as loss of appetite, loss of weight and fever are present. The sedimentation rate is almost without exception about 100 mm in the first hour. The two most frequent and typical clinical syndromes are polymyalgia rheumatica and cranial arteritis. The polymyalgia rheumatica is characterized by periarticular pain which is mostly symmetrical and accentuated in the shoulder girdle. Increasingly severe temporal headache and ocular distrubances are found with cranial arteritis in more than 50% of cases. A combination of both diseases is frequent. Other arterial branches are rarely involved. The course of the disease is over a period of 1 1/2 to 2 years. Treatment with corticosteroids is indicated mainly because of the severe ocular complications with blindness. It should begin immediately, be intensive and last over a long period. Regular followup is necessary over several years in order to avoid relapses.
 ...
PMID:Giant cell arteritis (cranial arteritis, polymyalgia rheumatica). 8 Dec 71

The authors report 40 cases of temporal arteritis, of which 16 were associated with pseudo-polyarthritis, and 8 cases of polyarthritis alone. The clinical picture of temporal arteritis in the elderly, includes headaches in 95% of cases, clinical changes in the superficial head arteries in 75% of cases, joint and muscle signs dominated by pseudo-polyarthritis in 40% of cases; general signs were practically constant. A major inflammatory syndrome was also constant. From the histological point of view, there was pan-arteritis with giant cells, and their wide diffusion is shown by the presence of eye signs in 27.5% of cases, brain signs in 10% of cases, and extra-cephalic vascular signs in 10%. The relationship in classification between temporal arteritis and polyarthritis of the roots of the limbs is recalled. The course is long, the duration of corticosteroid therapy should never be less than two years; relapses are common but the mortality appears low.
 ...
PMID:[Temporal arteritis and rhizomelic pseudo-polyarthritis. Clinical aspects and nosologic problems. Apropos of 48 cases]. 20 69

It is important to establish the diagnosis of temporal arteritis because the disease is treatable; treatment may prevent blindness and even death. Temporal arteritis usually occurs in people older than 51 years of age, although very rarely, histologically documented disease occurs in younger people. The onset may be occult, so that there are few findings. A multitude of signs and symptoms may occur such as fever, headaches, malaise, weight loss, anemia, stroke, cranial nerve palsies, polymyalgia rheumatica, aortitis and other large vessel involvement. The eye may suffer from ischemic optic neuropathy (anterior or posterior), central or cilio-retinal arterial occlusion, ophthalmic artery ischemia, or extraocular muscle palsies. An arterial biopsy showing giant cell arteritis establishes the diagnosis. However, a negative biopsy does not rule out the disease because of the occasional presence of skip areas. Arteriography has only rarely yielded a positive temporal artery biopsy when the initial biopsy done elsewhere was negative. As a diagnostic parameter, the erythrocyte sedimentation rate is nonspecific, being elevated in diseases other than temporal arteritis and sometimes being falsely lowered by technical factors. Furthermore, the temporal artery biopsy is occasionally positive despite a normal erythrocyte sedimentation rate. Treatment is aimed at relieving the patient's symptoms and normalizing the erythrocyte sedimentation rate. Because of the wide spectrum of clinical and laboratory finding in temporal arteritis, no one specific treatment regimen with systemic corticosteroids works for all patients. Temporal arteritis is a well known disease of the elderly which ir rarely fatal but results in significant visual morbidity (Hinzpeter & Naumann, 1976; Spencer & Hoyt, 1960). Since Hutchinson's (1890) description, more than a thousand articles have been written on the subject (Cohen & Smith, 1974). Despite this, many unanswered questions and controversies remain concerning the diagnosis, prognosis and treatment of temporal arteritis. My goal is to review these questions and areas of controversy.
 ...
PMID:Controversies regarding giant cell (temporal, cranial) arteritis. 39 20

Sixty-eight patients with giant cell arteritis (GCA) are described. In 42, histological evidence of arteritis was recorded at biopsy of a temporal artery. Twenty-six patients were included according to clinical criteria. In 20 patients the onset of illness was associated with an infection. The first symptom was: in 30 patients, muscle pains; in 14, fever; in 11, headache with temporal localization, and in 13 patients, tiredness and anorexia. In all, 50 patients had muscular symptoms and 30 had symptoms of localized temporal arteritis. In 5 patients neither muscular symptoms nor localized arteritis were found. A high erythrocyte sedimentation rate was seen in all cases and elevated platelet count was found in 24 patients. Abnormal liver function was a common finding, whereas impaired renal function was not observed. In 8 cases reversible eye symptoms were noted and reduced hearing capacity was demonstrated in 5 patients.
 ...
PMID:Giant cell arteritis. Clinical features and involvement of different organs. 72 50

In this paper the painful syndromes of temporal arteritis, polymyalgla rheumatica, glaucoma, trigeminal neuralgia, post-herpetic neuralgia, and temporomandibular joint dysfunction have been described. These conditions occur commonly in the elderly. The dangers of blindness occurring in temporal arteritis or polymyalgia rheumatica, the importance of early diagnosis in glaucomatous headache, the value of Tegretol in trigeminal neuralgia, the paucity of therapeutic agents in post-herpetic neuralgia and the value of dental treatment in tempor-mandibular joint dysfunction have been stressed.
 ...
PMID:Chronic pain syndromes in the elderly. 88 Jan 67

Headache may be the presenting symptom of many diseases in the elderly. Some headaches are caused by significant intracranial disease, and the patient's age and general cardiologic and respiratory status may not allow investigation or neurosurgical management. Conditions that demand urgent neurosurgical attention are subarachnoid hemorrhage, pituitary apoplexy, subdural hematoma, and meningioma. Cranial arteritis, too, should be remembered as a possible medical cause of headache in the elderly.
 ...
PMID:Differentiating causes of headache. 88 44

A 65-year-old woman had intermittent episodes of blindness. Although severe atherosclerotic changes were documented angiographically, definite radiographic evidence of arteritis also was present. A temporal artery biopsy was diagnostic for giant cell arteritis. Despite high-dose corticosteroid treatment, the patient became blind. A Westergren sedimentation rate of greater than 40 mm/hr in a patient over age 50 with headache, constitutional complaints, or visual symptoms is presumptive evidence of giant cell arteritis and demands further investigation. Prompt treatment with prednisone in high doses may prevent visual loss. At times angiography may be helpful in diagnosis of this illness or in selection of a biopsy site.
 ...
PMID:Angiographic findings in giant cell arteritis. 88 65

Temporal arteritis (granulomatous inflammation) usually involves the temporal and ophthalmic arteries, but may be part of a more widespread inflammation of the medium and large vessels. The patient usually presents with an associated group of constitutional symptoms (fever, malaise, anorexia, weight loss, anemia) and rheumatic complaints (polymyalgia rheumatic complaints (polymyalgia rheumatica). The diagnosis should be considered in any patient over 55 years old in whom these symptoms develop or in whom there is evidence of recent onset of headache, visual loss of localized arterial involvement. The diagnosis is also to be considered when the erythrocyte sedimentation rate is over 50 mm/hr, and the presence of arteritis is confirmed by temporalartery biopsy findings. Visual loss may occur in 50 percent of affected patients; other serious complications are less common. A strong clinical suspicion of temporal arteritis will permit diagnosis of the more uncommon and atypical presentations of the syndrome. Although cases of temporal arteritis may be self-limited, treatment is imperative because of the threat of blindness. Patients respond well to steroid (prednisone) therapy, which should be maintained for a prolonged period.
 ...
PMID:Temporal arteritis. 90 43

Older people often describe their headaches as starting with vague neck discomfort and eventually moving to the temples and forehead. These are muscle-tension headaches, by far the most common type in the elderly. Although cervical osteoarthritis often is at fault, depression can be a significant factor, patricularly when headaches are chronic. There is no sure cure for tension headache, and often, several of the many remedies-ethyl chloride spray, moist heat, massage, antidepressant drugs, analgesics, local anesthetics, etc.-must be tried before an effective one is found. But just as important to successful therapy are concern, compassion, and a willingness to listen on the part of the physician. True migraine headaches are rare in the elderly. More prevalent is the type of vascular headache associated with giant cell arteritis, which is severe and resistant to any form of analgesic except the strongest narcotics. Vascular headaches also may result from congestive heart failure (which produces venous congestion in the cranial cavity), transient ischemia, increased intracranial pressure, and a variety of metabolic disturbances.
 ...
PMID:The types of headache that affect the elderly. 95 13

In an elderly man bilateral temporal scalp necrosis complicating temporal (systemic giant cell) arteritis developed. The patient also demonstrated other features characteristic of this entity: (1) exquisite scalp tenderness and headache, (2) onset late in life, (3) visual disturbances, (4) general debility, (5) diagnostic temporal artery biopsy, and (6) gradual healing with glucocorticosteroid therapy. A computer assisted review revealed 13 similar cases of scalp necrosis associated with temporal arteritis published in the English literature.
 ...
PMID:Bilateral scalp necrosis in temporal arteritis. A rare complication of Horton's disease. 97 48


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