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)

A 63-year-old woman with psoriatic arthritis developed arthralgias and shoulder girdle myalgias which were controlled with amitriptyline. Some months later she presented with headache, jaw claudication, weight loss, and chest pain. Anemia of chronic disease, cholestasis, steatorrhea, and pericardial effusion were noted. Giant cell arteritis (GCA) was diagnosed on temporal artery biopsy and prednisone was begun. Her symptoms rapidly abated but steatorrhea continued. It is suggested that these problems were related to GCA. Physicians need to be alert to the diverse presentations of GCA.
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PMID:Giant cell arteritis associated with pericarditis and pancreatic insufficiency in a patient with psoriatic arthritis. 271 1

Although temporal arteritis (TA) is a common vasculitis, mental status changes and higher cortical dysfunction have received limited attention in the literature. We report a case which illustrates the potential for TA to produce chronic fluctuating delirium, delusional thinking, and memory impairment in the absence of concomitant symptoms of headache and visual loss. In addition, TA may produce differing symptoms at different times in the same patient.
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PMID:Mental status abnormalities in temporal arteritis: a treatable cause of dementia in the elderly. 280 29

This paper contains a review of the signs and symptoms of giant cell arteritis, especially speech and respiratory manifestations of the disease, which are demonstrated by a new case history. An elderly woman presented with speech that was falsetto, breathy, and marked by downward pitch breaks and phonation breaks. In addition, she had visual loss, headache, edema along the scalp and pharyngeal arteries, polymyalgia rheumatica, elevation of Westergren erythrocyte sedimentation rates, and positive arterial biopsy results. Her speech disorder recurred during an exacerbation. A vascular mechanism is proposed to explain her unusual speech, acute recurrence, and rapid recovery. This explanation (reversible ischemia of the laryngeal musculature) has been proposed by other authors in previous studies.
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PMID:Speech pathology in giant cell arteritis. Review and case report. 281 76

Giant cell arteritis (GCA) may present as pyrexia of unknown origin with profuse night sweats, pain on mastication, headache, pain in the region of the temporal arteries, polymyalgia rheumatica, myocardial infarction or dissecting aortic aneurysm. Few cases with pulmonary involvement have been described. We report a patient with temporal arteritis preceded by pulmonary vascular disease.
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PMID:Giant cell arteritis with pulmonary involvement. 316 24

In 67 patients with giant cell arteritis (GCA) and 133 control patients, the value of eight clinical parameters and five laboratory findings for the diagnosis of GCA was analyzed. Out of the clinical parameters characteristic for GCA, headaches, visual disturbance, pains of the shoulder or hip regions and fever were of diagnostic value. Of the laboratory findings, only the BSR was of diagnostic value. Inappetence, exhaustion and fatigue, although characteristic of GCA, as well as blood count, alpha-globulins, CRP and alkaline serum phosphatase were of no value in differentiating between GCA and other diseases. Each of the valuable parameters increased the probability of diagnosing GCA from 33% (incidence of GCA in our patients) up to between 48% and 52%. The simultaneous evaluation of several parameters elevated the probability of diagnosing GCA to up to 88%. These results provide a basis for a rational decision in favor of or against biopsy of the temporal artery. In the case of a negative histology, they help to decide in favor of or against long term corticoid therapy.
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PMID:[The value of anamnesis, clinical findings and laboratory parameters in the diagnosis of giant cell arteritis]. 323 46

100 patients, from three internal medicine departments, were the subject of a retrospective study concerning the clinical manifestations and the evolution of Horton's disease. The mean age is 71 years, with a 2/1 female predominance. A temporal artery biopsy was obtained in all cases. Besides the prevalence of clinical symptoms (headaches: 80 p. cent; weight loss: 78 p. cent; fever: 65 p. cent; local inflammation: 52 p. cent, frequent pseudo-polyarthritis: 40 p. cent and sometimes severe ocular localizations (11 p. cent blindness), other signs should be emphasized: muscular pain (49%), skin hyperesthesias (37%), painful jaw (33%), etc. The inflammatory syndrome dominates the biological picture (96%); the alkaline phosphatases are increased in 37 p. cent of cases. Temporal artery biopsy was positive in 82 p. cent of cases, which confirms the excellent sensitivity of this test, preceded by a Doppler study in only 28 cases. Extension of the inflammatory process to the large vessels was demonstrated 8 times, on clinical data. Finally, the mean length of the steroid treatment was two years with 14 relapses and 8 deaths.
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PMID:[Clinical and developmental aspects of Horton's disease. Retrospective study of 100 cases]. 328 62

A 79-year-old woman was admitted to hospital complaining of chest pain, increasing weakness, anorexia, hoarseness, headache and discomfort in the throat and jaws while eating. Physical examination, chest x-rays, serial electrocardiograms and cardiac enzymes were unremarkable. After admission she developed weakness and numbness in the left leg with urinary retention, decreased sensation to touch, weakness, increased tone, absent deep tendon reflexes and a positive Babinski sign on the left. Zeta sedimentation rate was markedly elevated at 0.63. Computerized tomographic head scan, myelography, echocardiography, barium swallow and meal, immunoglobulins, electrophoresis and other laboratory investigations were unremarkable. Repeat sedimentation rate was still markedly elevated three weeks later. A temporal artery biopsy confirmed the diagnosis of temporal or giant cell arteritis. Prednisone, 60 mg daily, was started.
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PMID:Acute chest pain in an elderly woman. 337 98

An elevated erythrocyte sedimentation rate is regarded as a hallmark of temporal arteritis. Thirty-five cases of biopsy-proved temporal arteritis without an elevated erythrocyte sedimentation rate are identified, and a 36th case is described. All patients had age-adjusted normal Westergren sedimentation rates, 16 with sedimentation rates of 20 mm per hour or less and 20 with sedimentation rates of 21 to 40 mm per hour. Twenty-two patients had sufficient clinical information for analysis and comparison with reported series of patients with biopsy-proved temporal arteritis with an elevated Westergren sedimentation rate. Headache (41 percent), temporal artery abnormalities (41 percent), and visual symptoms (36 percent) were the most common manifestations in patients without an elevated sedimentation rate. Headache (41 percent versus 75 percent, p less than 0.05) and jaw claudication (9 percent versus 43 percent, p less than 0.025) were found less often in the patients without an elevated sedimentation rate. History and physical examination are essential in the diagnosis of temporal arteritis with a normal Westergren sedimentation rate.
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PMID:Temporal arteritis without an elevated erythrocyte sedimentation rate. Case report and review of the literature. 351 41

To assess the diagnostic usefulness of temporal artery biopsy in temporal arteritis (TA) and establish clinical features capable of predicting its positivity we have retrospectively studied the biopsy specimens and the clinical features of 103 patients who had undergone temporal artery biopsy. Temporal artery biopsy reached a positive predictive value of 90.2% with respect to the final diagnosis based on the criteria proposed by Ellis and Ralston and the clinical course. The simultaneous presence of recent onset headache, jaw claudication, and abnormalities of the temporal arteries on physical examination had a specificity of 94.8% with respect to the histological diagnosis and of 100% with respect to final diagnosis. The presence of any of these clinical features, though of little specificity (34.4%), had a sensitivity of 100% with respect to histological diagnosis, selecting a group of patients in whom temporal artery biopsy has more discriminative value.
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PMID:Clinical usefulness of temporal artery biopsy. 359 83

Forty-five consecutive patients (32 women and 13 men) underwent biopsy of the temporal artery because of suspected giant cell arteritis. Their ages ranged from 38 to 84 years, mean 68.1 years. Five patients (11.1%) four of them women, were found to be affected by the disease. Their ages ranged from 54 to 80 years, mean 69 years. Clinical and laboratory findings included elevated erythrocyte sedimentation rate, prolonged fever, continuous headache, sudden onset of unilateral blindness, intermittent mandibular claudication, severe anemia and myalgia. None of these, whether present in isolation or in various combinations, were of significant diagnostic value. All biopsies were examined both by light microscopy and by scanning electron microscopy. The former examination took about 5-7 days to complete, and the latter about 3 hours. Light microscopy studies showed that 46.6% of the arterial biopsies were normal, 42.3% were arteriosclerotic and 11.1% (5 specimens) were characteristic of giant cell arteritis. Scanning electron microscopy revealed that the biopsies obtained from all five patients found to have temporal arteritis displayed the "occlusive" pattern: the three-laminar appearance of the artery was markedly distorted or lost, the internal elastic lamina was barely detectable, and the densely hypertrophied media and intima filled the arterial lumen, virtually obliterating it. We conclude that scanning electron microscopy is a quick and accurate procedure for diagnosis of temporal arteritis and that positive findings may be taken as an indication for immediate steroid treatment.
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PMID:Scanning electron microscopy as a diagnostic procedure in giant cell arteritis. 366 83


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