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)

Several preliminary studies drew attention to the value of Doppler examination in temporal arteritis. This study involving 59 cases aimed to define the value of Doppler examination in the diagnosis of the disease, evaluation of ophthalmic risk and in the monitoring of treatment. The study involved 59 patients and 47 controls with no evidence of temporal arteritis, but of comparable mean age. The following arteries were investigated before treatment: arteries of limbs, subclavian, vertebral, carotid, temporal, occipital, facial and ophthalmic recorded via the internal nasal branch and also transocularly. The results were expressed in the form of a score from 0 to 3 describing the degree of deterioration of the curves. A mean score corresponding to the mean of the scores of the cephalic arteries was calculated for each patient and each control. The specificity and sensitivity of the investigation were studied, based on this mean score by ROC analysis. The progression under treatment was monitored for more than 24 months in 20 patients divided into 3 groups: group I: 6 patients cured; group II: 6 patients with late recurrence of temporal arteritis after steroid withdrawal; group III: 8 patients with progressive disease. 81.5% of temporal arteries were pathological, including 60% with tight stenosis (score 2 and 3). Morphological anomalies in the curves were also noted at the level of the occipital arteries (69%), facial arteries (80%), as well as the ophthalmic artery at both recording sites (internal nasal: 84.5%, transocular: (73%) (table I).(ABSTRACT TRUNCATED AT 250 WORDS)
J Mal Vasc 1989
PMID:[Significance of arterial Doppler in Horton's disease. Prospective study of 59 case reports]. 269 68

Epidemiological studies of temporal arteritis have essentially only been reported in the English literature. The authors of this study were concerned with this aspect of temporal arteritis in the Loire-Atlantique region of France over a period of 10 years (1970-1979). The high prevalence in white races has been confirmed. The annual incidence in France is comparable to that seen in Northern Europe and the USA. The incidence of the disease is especially high between 70 and 80 years. The apparent female predominance is related to the greater life expectancy in women. The study of several conjugal cases does not suggest the intervention of an infectious agent. The same is true for isolated cases where the responsibility of a bacterial or viral agent has not been demonstrated. Other environmental factors (sun exposure, life-style, socio-professional classification) do not affect the incidence of the disease. The genetic background would seem to be of particular importance. This study found a significantly higher prevalence of HLA DR4 antigen, confirming the results of American and British studies. However, in contrast to previous studies, this series did not confirm an increase in HLA B8 antigen.
J Mal Vasc 1989
PMID:[Epidemiology of Horton's disease. Is there an environmental factor, infective in particular?]. 269 69

The etiopathogenesis of temporal arteritis and rhizomelic pseudo-polyarthritis still remains undefined. A genetic predisposition would seem probable in view of epidemiological data (higher frequency in white caucasian races and in certain countries), the existence of rare familial forms (25 families reported), and the significant increase in incidence in unconnected cases with HLA DR4 antigen (6 studies). Environment may intervene as a precipitating factor in the condition and the role of an infectious agent, to account for the seasonal incidence of this disorder and the rare existence of cases in non consanguineous couples, has been suggested but remains unproven. Disordered immune function probably plays an essential role in the creation of the vascular histological lesions characteristic of the condition. The disordered function involves cellular immunity (fall in OK T8. in blood) and especially humoral immunity with the very frequent presence of circulating immune complexes in the serum and deposition of immunoglobulins and complement at arterial wall level.
J Mal Vasc 1989
PMID:[Immunogenetics of Horton's disease and of rhizomelic pseudo-polyarthritis]. 269 70

716 cases collected from 9 recent studies published between 1981 and 1985 served as a basis for a general review of the current treatment of temporal arteritis. Steroid therapy was instituted as first intention in 652 cases, high dose treatment was continued for between 8 days and 3 months but the majority of authors started a reduction in the dosage from the 4th or 5th week. There was no overall agreement regarding the duration of maintenance therapy nor the criteria allowing its discontinuation, and withdrawal was not possible before the 25th month on average. The ideal initial dosage, in the absence of randomized studies, remains to be defined: generally around 0.5 mg/kg/d in milder forms, the dosage may be increased to 1 mg/kg/d in the presence of complicated temporal arteritis. Besides cortico steroid therapy, other treatments are successively envisaged: synthetic anti-malarials (SAM), non steroidal anti-inflammatories (NSAI), dapsone... while these are generally used as back-up treatment, David-Chausse used SAM as first intention, combined in 17 cases with NSAI in 61 of his 66 patients, with very promising results which require confirmation in other studies. In this review the cure rate was around 25% and the relapse rate 38%; complications related to the disease occurred in 19%, while almost one patient in two--47%--developed iatrogenic complications. Blindness dominates the prognosis, and occurred in 15% of cases, most often as an inaugural event, it very rarely regressed on steroid treatment. Although death occurred in 18% of cases, the prognosis of temporal arteritis generally remains favorable, with a 5 year survival curve identical to a control population.
J Mal Vasc 1989
PMID:[Treatment of Horton's disease]. 269 71

In 1932, Horton, Magath and Brown reported two cases of a "new form of arteritis affecting the temporal vessels ... which probably represents a new clinical syndrome". In reality, several publications, devoted to the same pathology already preceded this article. The most ancient is that of an ophthalmologist from Baghdad, Ali Ibn Isa (940 to 1010). In his memories, translated and published in english in 1936, the author states that "he undertook excision and cauterisation of arteries to treat patients who were suffering from heat and inflammation of their temporal muscles and which sometimes ended in loss of vision ...". In 1890, J. Hutchinson, an English surgeon, reported a case "... of inflammed and swollen temporal arteries ...". This article was only brought to light in 1946. In 1930, M. Schmidt, published a probable case of temporal arteritis, subsequently reported in 1947. In 1934 and 1936, Horton published new cases of temporal arteritis and defined the clinical characteristics of the disease and its histology. In 1938, Jennings made a particular contribution in reporting the first case of blindness. From this time on, cases of temporal arteritis became increasingly common in the literature. The first French case was described by J. Paviot et al. in 1934, but remained largely unrecognized until 1942. In 1936, J. Chavany was the first to describe the pillow sign, but more particularly in 1948, he prescribed the first treatment with steroids, with spectacular results. It was only in 1950 that R.M. Shick et al. published the effects of steroid therapy in temporal arteritis.(ABSTRACT TRUNCATED AT 250 WORDS)
J Mal Vasc 1989
PMID:[The history of Horton's disease or ... 10 centuries of a fascinating adventure]. 269 72

Stiffness of the jaw was noted in the first descriptions of temporal arteritis. It was only in 1944 that Horton used the term intermittent claudication and related this sign to effort ischemia due to thrombosis of facial arteries. The introduction of ultrasound techniques has enabled the permeability of facial arteries to be confirmed in spite of induration and absence of pulsatility clinically. Anatomical studies have defined the preponderant role of the internal maxillary artery in the vascular supply of the masseter muscles and have enabled the localization of an appropriate and reliable site for ultrasound study: the pterygo-maxillary fossa. The velocimetric data thus collected confirm that the internal maxillary artery is affected and define the etiopathogenesis of intermittent jaw claudication during temporal arteritis. This sign is observed on average in one patient in three suffering from temporal arteritis. While several cases of intermittent jaw claudication have been described in severe atheromatous stenosis of the common carotid or external carotid arteries, or in relation to other causes (rheumatological, neoplastic, psychological ...), the observation of this syndrome in a suspicious clinical and paraclinical context constitutes an excellent orientation sign in favor of temporal arteritis.
J Mal Vasc 1989
PMID:[Intermittent claudication of the jaw in temporal arteritis]. 269 73

Ten patients aged from 60 to 73 years presenting with Horton's disease or polymyalgia rheumatica had arteritis of the upper limbs. Asymptomatic abolition of pulse in the upper limbs (1 case) or claudication at rest or exercise (9 cases) and/or Raynaud's phenomenon (5 cases) preceded (4 cases) or accompanied (1 case) the discovery of giant cell arteritis, or complicated the reduction or discontinuation of corticosteroid therapy. Diagnosis rested on the regular association of an inflammatory syndrome with multiple arterial tapered stenoses and/or arterial thrombosis in the post-vertebral subclavian, axillary or brachial arteries and, chiefly, on the demonstration (in 7 cases) of a giant cell granuloma at biopsy of the temporal artery. Corticosteroid therapy (1 mg/kg/24 h in 8 cases and 0.5 mg/kg/24 h in 2 cases) initially combined with anticoagulants in 4 cases resulted in rapid regression of ischaemic and systemic signs in all patients, thus avoiding surgical revascularization of the upper limbs.
Arch Mal Coeur Vaiss 1988 Jan
PMID:[Subclavian and axillary arteritis in Horton's disease and rhizomelic pseudopolyarthritis. 10 cases]. 313 26

The many common factors linking rhizomelic pseudopolyarthritis and Horton's disease prompt to compare their respective evolutions and the long-term results of their treatments. The comparative study of 28 patients with temporal Horton's arteritis, proven histologically, and 28 rhizomelic pseudopolyarthritis without arteritis on biopsy, in a total population of 95 patients, confirms the similarity of their clinical and biological signs and show a closely related evolution in the three groups. The evolution leads to a cure approximately 16.4 +/- 14 months in 41 p. cent of the cases. 34 p. cent of the patients are at an advanced stage with a mean follow-up of 37 months and relapses during the weaning period were frequent. 25 p. cent of the patients died. Most deaths occur in the first month of the disease, and occur readily in patients who have received a short treatment with steroids discontinued because of a iatrogenic accident. Cerebral vascular accidents and coronary accidents, arterial hypertension and iatrogenic gastro-intestinal ulcerations are the most frequent complications.
Rev Rhum Mal Osteoartic 1987 Jan
PMID:[Horton's disease and rhizomelic pseudopolyarthritis. Developmental data apropos of 95 cases]. 356 72

The authors report the results of a retrospective therapeutic survey concerning 176 cases of rhizomelic pseudopolyarthritis (RPP) and 66 cases of temporal arteritis (TA). Of 128 cases of RPP treated initially by synthetic anti-malarials (SAM) and non-steroidal anti-inflammatory agents (NSAI), 66 were followed up until cure which was obtained after a mean of 23 months and 3 subsequently received brief steroid therapy. 45 cases of RPP were treated initially with corticosteroids. They were generally associated with SAM which enabled early weaning of the steroids, towards the 8 th month, or at least reducing the dose. Cure was obtained within 24 months. Three patients were treated by NSAI and gold therapy. After cure, 5 cases of recurrence and 1 case of TA were observed. 40 cases of TA were initially treated with SAM and NSAI. Twenty cures were obtained within a mean of 28 months. 4 patients later received brief corticosteroid therapy because of an extension of the signs, including two cases of ocular manifestations with a resolving course. Of 25 cases of TA initially treated with steroids, 20 received SAM in combination, or in relay which enabled either steroids, weaning towards the 14th month or a reduction in the dose of steroids. Cure was obtained in an average of 35 months. One case of impaired visual acuity occurred during corticosteroid treatment. Immunosuppressants were used in one patient. No cases of recurrence were observed. Iatrogenic complications with SAM were rare, generally benign and reversible, in contrast to those associated with corticosteroid therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Rev Rhum Mal Osteoartic
PMID:[Results of a regional survey on the treatment of rhizomelic pseudopolyarthritis and temporal arteritis. Apropos of 242 cases treated by various modalities with synthetic antimalarials, corticoids and non-steroidal anti-inflammatory agents]. 663 10

The authors report two cases of Horton's disease and one case of rhizomelic pseudopolyarthritis treated initially with delta-cortisone with a very rapid favourable result. However, while under relatively high dose steroid therapy, there was recurrence of the disease in the three cases and the development of complications of steroid therapy prohibited the use of higher doses of delta-cortisone and even required its rapid weaning. In these three cases, the addition of 100 mg of dapsone per day led to a rapid control of the disease, with return to normal of the erythrocyte sedimentation rate and reduction of the doses of delta-cortisone. The authors discuss the place of dapsone in the treatment of Horton's disease and rhizomelic pseudopolyarthritis in the light of these three cases.
Rev Rhum Mal Osteoartic 1983 Apr
PMID:[Value of dapsone in the treatment of Horton's disease and rhizomelic pseudopolyarthritis]. 687 94


<< Previous 1 2 3 4 Next >>