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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 describe a case of histologically proven giant cell arteritis (GCA) in a 62-year-old woman who initially presented with upper limb girdle pain and weakness, and intermittent claudication. Clinical improvement was obtained with oral prednisolone. She subsequently developed a photosensitive rash and was diagnosed as having systemic lupus erythematosus. The features of the two conditions and the possibility of an association are discussed.
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PMID:Giant cell arteritis and systemic lupus erythematosus. 340 55

A 53-year-old patient with no past history of rheumatic fever or lues presented with severe aortic regurgitation, underwent hemodynamic evaluation, and subsequently, an uneventful aortic valve replacement. The initial pathological interpretation was nonspecific aortitis. Six months following surgery arthralgia, muscular pain, difficulty in mastication, and fatigue occurred. There was no fever, however, sedimentation rate was 100/130. Cardiac examination was normal. Review of the pathological specimens revealed granulomatous arteritis with giant cells, typical of giant cell arteritis. Though the association of aortic regurgitation and giant cell arteritis is well recognized, only two such cases of severe aortic regurgitation requiring valve replacements have yet been described, of them, one probably had Takayasu's arteritis. An accurate diagnosis is of importance since steroid treatment is effective, and if introduced early, the inflammatory process may be arrested.
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PMID:Severe aortic regurgitation: a rare presentation of giant cell arteritis. 376 38

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.
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PMID:Giant-cell arteritis. 379 80

Patients with temporal arteritis may be misdiagnosed because the headache does not affect the temples. The records of 24 patients with biopsy proven temporal arteritis were reviewed to determine the site and other qualities of headache. Past reports of the sites of headache in this disease were also reviewed. The temporal area was the sole site of headache in only six of 24 patients; the temple was included in pain that affected the frontal, vertex, and occipital areas in another seven patients. Two patients had generalized headaches. The headache did not involve the temple in seven patients and two patients did not experience headaches. Temporal arteritis should be considered in every elderly individual who begins to complain of headache, no matter what the site, quality, severity, or time pattern.
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PMID:The headache of temporal arteritis. 380 61

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.
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PMID:Polymyalgia rheumatica and giant cell arteritis. The dilemma of therapy. 400 Oct 42

From this and the previous article, the following points may be offered in summary: When comparing the elderly age group with the general population, the incidence of migraine headaches decreases with age, whereas other etiologies such as glaucoma, temporal arteritis, and cerebrovascular disease may assume a more prominent role in the differential diagnosis. Patients in the geriatric population are frequently taking a multitude of medications, and it is extremely important to carefully evaluate these for possible precipitants of headache. Furthermore, in elderly patients with other potential medical problems, particular attention should be paid to the possibility of various systemic causes of headache. Therapy for specific headache disorders should be tailored to the individual patient. Consider the patient's overall general, psychological, medical, and neurologic background. The physician must be aware of possible interactions of medications with the therapeutic intervention, as well as possible poor tolerance to specific medications due to preexisting medical or neurologic disorders. A complete history, obtaining information on the temporal pattern of headache, the distribution of pain, and precipitating and alleviating factors, is extremely important in evaluating the elderly patient. A careful physical examination, paying particular attention to possible disorders of extracranial structures, is indicated. A neurologic exam, including basic tests of higher cortical function, should be obtained. Important additional laboratory investigations include a complete blood count, erythrocyte sedimentation rate, and basic blood chemistries. Arterial blood gases should be obtained in patients who have pulmonary disease, a history suggestive of sleep apnea, or other disorders that may produce hypoxia and hypercarbia, resulting in vascular headache.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Headaches in older patients: Ddx and Tx of common nonvascular causes. 405 33

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.
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PMID:[Polymyalgia rheumatica--clinical observations on 90 patients]. 408 88

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.
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PMID:Maxillofacial pain. 646 48

A 72-year-old woman suffered from giant cell arteritis (GCA) which developed into lingual infarction and monocular blindness. Temporary obscuration of vision and lingual symptoms such as increasing malaise, pain and intermittent claudication may precede the catastrophic results of arteritis. Emphasis is laid on early recognition and treatment of GCA.
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PMID:Lingual infarction and sudden blindness due to giant cell arteritis. 662 40

A 79 year old woman is reported who has suffered pain in the jaws and mouth for several years. Giant cell arteritis was diagnosed by temporal artery biopsy after the appearance of severe temporal and frontal headache. Despite treatment with cortisone, sudden pain in the tongue appeared preventing speaking and swallowing and leading to ischemic necrosis of the anterior two thirds of the tongue. At the same time she had a transitory ischemic cerebral attack. Six almost identical case histories could be found in the literature: in three tongue necrosis was caused by histologically proven giant cell arteritis. From the clinical picture, giant cell arteritis could have been the cause of tongue necrosis in the other three cases.
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PMID:[Giant cell arteritis as a cause of tongue necrosis]. 670 9


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