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

Polymyalgia rheumatica as well as Horton's disease (arteriitis temporalis) are often diagnosed by exclusion. When either disease is suspected because of certain findings a therapy with glucocorticoids is usually started and initial therapeutic success is commonly seen as indirect proof of diagnosis. Clinical experience, however, shows that both diagnoses may conceal a malignancy. Based on this experience the cases of three patients are reported who's clinical and laboratory findings suggested first manifestations of polymyalgia rheumatica or Horton's disease respectively. During treatment, however, the true underlying disease was revealed in two of the cases. Only in one patient was the diagnosis polymyalgia correct, in the second patient a bronchial carcinoma was found, in the third a carcinoma of the breast with bone marrow carcinosis. All three patients have been presented to physicians participating in a meeting of general medicine in 1999. Before disclosure of the final diagnoses assumptions of the physicians about the initial diagnosis were analysed. The same procedure was used with last year medical students. Physicians had more correct diagnoses (19% had all three correct) than students (only 2.8%). This shows on one hand a marked general diagnostic insecurity concerning the diagnoses polymyalgia and Horton's disease on the other hand it demonstrates the advantage of medical experience gained during practice.
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PMID:[Pitfalls in diagnosis of polymyalgia rheumatica/temporal arteritis]. 1086 11

We performed a multicenter case-control study on incident cases of giant cell arteritis and polymyalgia, and tested for viruses known to induce multinucleated giant cells in human pathology. IgM directed against Human parainfluenza type 1 virus were shown to be significantly associated with the onset of the disease in 40% of the cases, versus 20% of the controls.
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PMID:Giant cell arteritis and polymyalgia rheumatica: role of viral infections. 1094 53

Primary systemic amyloidosis or AL-amyloidosis is an uncommon disease characterized by the accumulation in vital organs of a fibrillar protein consisting of monoclonal light chains. It is a plasma-cell dyscrasia related to multiple myeloma where clonal plasma cells in the bone marrow produce immunoglobulins that are amyloidogenic. A monoclonal component is present in the serum or urine of 90% of patients. The presentation of most patients with AL amyloidosis is usually related to congestive heart failure, nephrotic syndrome o peripheral neuropathy, but there are unusual features suggesting giant cell arteritis (GCA) and polymyalgia rheumatic (PMR). Although in the majority of AL cases the plasma cells clone is small, the assumption is that the outcome of the disease is uniformly fatal (median survival 12-15 months) and treatment is analogous to those used in malignant proliferative disease. We describe a patient with AL amyloidosis who presented with manifestations of GCA and PMR, and we review the main characteristics of primary amyloidosis.
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PMID:[Primary systemic amyloidosis presenting as polymyalgia rheumatica and giant cell arteritis]. 1149 41

Cranial arteritis (CA), also called giant cell arteritis or temporal arteritis, is a vasculitis primarily affecting adults over age 50. It is a large vessel vasculitis, and giant cells classically can be identified on histopathologic examination of temporal arteries, but are not essential for diagnosis. Patients typically present with severe headaches, fatigue, polymyalgia-like symptoms, or ischemic complaints such as jaw claudication. Visual loss is the major feared irreversible outcome and can occur in up to 50% of those with untreated disease. Glucocorticoids, typically high dose prednisone (> or = 60 mg/d) is the first-line treatment and successfully controls the inflammatory disease in the vast majority of patients. Most patients can be tapered off steroids within 6 months to 2 years.
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PMID:Inflammatory disease in older adults. Cranial arteritis. 1566 19

A 76-year-old woman with pulmonary asbestosis was admitted with fever and polymyalgia. She subsequently developed a visual disorder, hemoptysis, and hemoperitoneum. A biopsy of the temporal artery revealed the presence of giant-cell arteritis. CT and angiography showed hemorrhaging from the bronchial and abdominal arteries. These observations suggested temporal arteritis in which medium-sized vessels were involved. This case implies the association between vasculitis and asbestosis, and suggests a problem in the classification of vasculitides.
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PMID:A case of pulmonary asbestosis presenting with temporal arteritis involving multiple medium-sized vessels. 1815 68

The aim of the study was to analyze literature data on the etiology, pathogenesis, and clinical criteria of rheumatic polymyalgia (RP) as well as present-day possibilities of the treatment and monitoring of the disease. Today, RP is considered to belong to the group of system vasculites. The disease affects the elderly. No specific bacterial or viral etiological factors have been revealed. In 5 to 10% cases RP is combined with temporal arteritis (Horton's disease), although morphological changes in the temporal artery are found in 40% of RP patients. The clinical manifestation is unique; it includes pronounced myalgia in the upper brachial girdle, the pelvic girdle, and the neck, as well as increased ESR. Treatment with glucocorticoids (GK) in low doses has very quick positive effect. Gradual cancel of GK is artwork; to make it possible, B. Leeb and H. Bird developed the activity index (RPAI) in 2003. An RPAI of less than 7 is considered the target value. The length of GK administration depends on the severity of RP and the adequacy of dose lowering gradient. Thus, the clinical diagnosis of RP is not difficult; the monitoring of the disease should be performed using RPAI, trying to achieve its target value.
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PMID:[Rheumatic polymyalgia: the state of the problem]. 1821 49

A 76-year-old female was admitted to our hospital for investigation and treatment of aortic regurgitation. She was found to have an ascending aortic aneurysm extending to the proximal arch. She had not suffered from any symptoms except chest discomfort. Total arch replacement and aortic valvoplasty were performed under cardiopulmonary bypass. Pathological examination of the aneurismal wall revealed giant cell arteritis. Aortic aneurysm due to giant cell aortitis without such symptom as temporal pain or polymyalgia was considered to be very rare.
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PMID:[Thoracic aortic aneurysm due to giant cell arteritis without any specific symptom]. 1934 18

Gerontorheumatology deals with the particular features of onset, course and treatment of rheumatic diseases in patients of advanced age. The initial diagnosis of inflammatory rheumatic disease after the age of 60 is hindered by the frequency of non-specific general disease symptoms. The most important gerontorheumatological diseases include rheumatoid arthritis first occurring at advanced age ("late onset rheumatoid arthritis", LORA), rheumatic polymyalgia and giant cell arteritis. Important differential diagnoses in older rheumatology patients are RS3PE syndrome, polyarticular chondrocalcinosis and paraneoplastic rheumatic syndrome. In principle, all specific basic therapeutics, immunosuppressants and biologics can be used for the therapy of these diseases. However, careful dose selection is particularly necessary in the initial phase, taking age-specific limitations in organ function and metabolism into consideration; moreover, close-meshed tolerance tests should be carried out.
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PMID:[Gerontorheumatology. Aspects of diagnosis, course and therapy of inflammatory rheumatic disease in advanced age]. 1955 22

Problems of diagnosis (including early diagnoses) and treatment of giant cell arteritis the commonest form of vasculitis in subjects above 50 years. An aged woman presenting with rheumatic polymyalgia is described in whom cell arteritis was diagnosed by positron emission tomography. Etiology of this disease and it medicamentous treatment are discussed with reference to the patients' age and concomitant pathologies.
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PMID:[Takayasu syndrome in Horton's disease]. 2060 71

Giant cell arteritis (GCA) is a chronic vasculitis that typically presents with headache, fever and polymyalgia although atypical presentations are known. We present a case of GCA with nonproductive cough and pyrexia of unknown origin emphasizing this atypical nature of presentation. We report a rare association of GCA with granulomatous hepatitis. We also support the use of PET scanning in diagnosing and monitoring this condition.
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PMID:An unusual presentation of giant cell arteritis. 2281 25


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