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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The most frequently recognized clinical features of giant cell arteritis (GCA) derive from the involvement of the cranial arteries. In 10% of patients, however, the aorta and its major branches, are also affected. We report a case of a 53-year-old woman presenting with a fainting episode and diminished pulses in the upper extremities. Histologic examination of the temporal artery revealed features of giant cell arteritis.
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PMID:Giant cell arteritis presenting as pulseless disease of the upper extremities. 892 86

GCA presents in various forms, creating a diagnostic conundrum for the treating physician. Evaluation requires extensive medical examination, testing, and imaging to rule out other conditions. Compared with the process of diagnosing GCA, treating it is relatively straightforward. Most patients show significant improvement with corticosteroid therapy. Our patient presented with syncope, which also has numerous causes. Detailed testing confirmed a positional trigger for her syncope in the absence of hemodynamic disturbances. She responded promptly to corticosteroid therapy. We speculate that flow-limiting stenosis in the vertebrobasilar system may have caused her symptoms.
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PMID:Giant cell arteritis. Episodes of syncope add complexity to an unusual presentation. 1108 74

The objective of this prospective study was to investigate further the clinical features of patients with giant cell (temporal) arteritis (GCA). All patients diagnosed from July 1999 to March 2001 at the Department of Neurology of the Second Xiangya Hospital in China were included. The final diagnosis was based on clinical manifestations, a temporal artery biopsy, response to steroid, and follow-up. The American College of Rheumatology (ACR) criteria for the classification of GCA were tested in the patients identified. Sixteen patients with GCA were identified; 13 (81.25%) patients fulfilled the 1990 ACR criteria for the classification of GCA. Clinical findings included the following: mean age at disease onset 43.13 years (range 28-60) and 81.25% of the patients under the age of 50 when the disease began; men 93.75%; the common initial symptoms including new headache 62.50% and.visual symptoms 18.75%; the common clinical findings at presentation including new headache 93.75%, temporal artery abnormality 81.25%, visual abnormality 56.25%, and fever 25.00%; raised erythrocyte sedimentation rate (ESR) 68.75%; and uncommon findings including jaw claudication, ptosis, fatigue, syncope, hemiparesis; all 16 patients underwent a temporal artery biopsy; inflammatory cell infiltration 68.75% in arterial wall, fragmented internal elastica 100.00%, fibrinoid necrosis 18.75%, smooth muscle cell changes 62.50%, and thrombosis in the lumen 31.25%. The mean time from symptom onset to suspicion of GCA or biopsy was 5.52 months (range 0.25-24.33); the initial diagnosis was wrong in 87.50% of patients. These examples are too small a number to permit definite conclusion. But the results suggest that GCA may not be a rare disorder in China, mean age at disease onset was relatively young, males may be more susceptible, the clinical features of GCA have not been widely appreciated yet, there was a delay between diagnosis and treatment, and initial diagnosis was wrong in many patients.
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PMID:Giant cell arteritis in China: a prospective investigation. 1214 52