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

Temporal arteritis is a systemic disease with local temporal artery symptoms, generalized constitutional symptoms and ocular involvement which affects the elderly. A study was undertaken to assess the clinical features of patients with temporal arteritis in a large multispecialty clinic practice. The study group consisted of 516 patients with clinical suspicion of temporal arteritis, of which 97 (18.8%) had a positive biopsy for arteritis. The records of these 74 females and 23 males were retrospectively reviewed for clinical implications of the disease. The average age of the cohort was 71.7 years, and male to female ratio was 1:3.2. There were 95 caucasians and 2 blacks. The most common clinical findings at presentation were abnormal temporal artery (65.9%), headache (64.8%), myalgias or arthralgias (46.6%), visual symptoms (37.1%) and fever (35.1%). Multiple symptoms were present in 97% of the patients. The erythrocyte sedimentation rate was > 50 mm per hour in 91% of patients. Corticosteroids were used to treat 95/97 patients. Twenty-seven (28%) of the patients completed treatment over an average 36.3 months. Sixty-eight (72%) other patients were either lost to follow-up, died, or continue on therapy. Complications of corticosteroid treatment occurred in 43 (44.3%) of patients, and complications of temporal arteritis occurred in 14 (14.4%). A review of biopsy data showed no difference in length of biopsy or yield of biopsy in the patients with positive and the patients with negative histology. Temporal arteritis is a systemic disease which responds well to corticosteroid treatment. Complications of the disease as well as of treatment make definitive diagnosis imperative.
J Cardiovasc Surg (Torino)
PMID:Temporal arteritis. Clinical implications for the vascular surgeon. 144 81

Giant cell arteritis is a rare, poorly understood, and often misdiagnosed entity. A case is reported of giant cell arteritis in a 30-year-old white male who developed severe bilateral peripheral claudication affecting both legs. The erythrocyte sedimentation rate (ESR) was markedly elevated. The diagnosis of vasculitis was established by histology postoperatively following exploration of both superficial femoral arteries and the placement of a reversed saphenous vein bypass graft to the right leg. Biopsy of the temporal artery revealed no pathology. The patient has been completely asymptomatic postoperatively and has resumed all previous normal activities. This condition has persisted in spite of a failed graft determined by an arteriogram performed 3 months after surgery. He has been treated with steroids continuously since the procedure.
J Cardiovasc Surg (Torino)
PMID:Bilateral superficial femoral giant cell arteritis. 219 69

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.
J Cardiovasc Surg (Torino)
PMID:Scanning electron microscopy as a diagnostic procedure in giant cell arteritis. 366 83

43 patients with thoracic aortic aneurysms (TAA) were treated over a ten-year period at our hospital. Five (11.6%) had giant cell arteritis (GCA). Although many types of arteritis have been reported, all have pathologic features of elastic degeneration and granulomatous inflammation and may share a common underlying etiology. TAA secondary to arteritis frequently involves the ascending aorta, leading to aortic root dilatation and valvular insufficiency. Three of five of our patients had these findings and had successful surgical repair by combined aortic valve and ascending aorta replacement. Patients with TAA secondary to arteritis should be investigated further, looking for evidence of additional arterial disease. Because corticosteroids have prevented the progression of other types of arteritis, further investigation of their efficacy in the treatment of giant cell arteritis may be warranted.
J Cardiovasc Surg (Torino)
PMID:Thoracic aortic aneurysm secondary to giant cell arteritis: a reappraisal of etiology, treatment and possible prevention. 403 Aug 82

It has been reported sporadically that several types of coronary arteritis can result in myocardial infarction. Recently, we treated a 27-year-old with acute anterior myocardial infarction. Primary directional coronary atherectomy was performed in order to recanalize the totally occluded coronary artery. The atherectomized tissue consisted of thrombi and intima infiltrated with inflammatory cells and multinucleated giant cells. Underlying diseases which can result in giant cell arteritis were excluded. This report documents that coronary arteritis can induce acute myocardial infarction, and that directional coronary atherectomy can be an effective tool in the diagnostic method for coronary arteritis.
Cathet Cardiovasc Diagn 1994 Nov
PMID:Acute myocardial infarction in a young adult due to solitary giant cell arteritis of the coronary artery diagnosed antemortemly by primary directional coronary atherectomy. 787 20

Horton giant cell arteritis of the legs is a very rare and unusual occurrence. A very interesting case of acute ischemia of the right leg in a 51-year-old woman treated with emergency thromboendarterectomy is described. Histological findings led to the diagnosis of Horton giant cell arteritis and the patient was submitted to steroid and vascular therapy. Good results were obtained and follow-up after five years confirms the good general condition of the patient.
J Cardiovasc Surg (Torino) 1997 Jun
PMID:Horton giant cell arteritis of the legs. Report of a case. 921 84

Giant cell arteritis is a medium-vessel vasculitis that affects both men and women. Because the disease commonly presents with nonspecific complaints stemming from cranial arterial insufficiency, the challenge for the physician is recognizing the diagnosis. Recognition of the entity and expeditious initiation of therapy are required to prevent permanent complications, including blindness. There is no pathognomonic finding on physical examination, blood testing, or commonly used radiologic investigations to confirm the diagnosis or establish disease activity. Oral corticosteroids are the mainstay of therapy. Other immune system modulators have no demonstrated efficacy and require further investigation. Percutaneous or surgical revascularization is a viable therapeutic option when the disease is not active.
Curr Treat Options Cardiovasc Med 2000 Jun
PMID:Giant Cell Arteritis. 1109 26

A 74-year-old woman underwent elective double valve replacement (aortic and mitral) for rheumatic valvular disease. She failed to wean from cardiopulmonary bypass due to marked left ventricular dysfunction. At autopsy, severe giant cell arteritis confined to the intramural coronary arteries was seen. Furthermore, there were multiple areas of recent microscopic myocardial infarction around the intramural coronary arteries. This report describes a rare case of giant cell arteritis confined to intramural coronary arteries which lead to inadequate myocardial protection at the time of surgery.
J Cardiovasc Surg (Torino) 2002 Oct
PMID:Giant cell arteritis confined to intramural coronary arteries. Unforeseen hazards myocardial protection. 1238 76

The purpose of this study was to evaluate the safety and effectiveness of percutaneous transluminal angioplasty for occlusive arterial disease associated with vasculitis. Eleven patients (10 women, 1 man; ages 35-82 years) with the diagnosis of vasculitis of the large vessels underwent interventional treatment during intraarterial angiography. The causes included giant cell arteritis (n = 8) and Takayasu arteritis (n = 3). Thirty-three occlusive lesions (including brachiocephalic and renal arteries, and arteries of upper and lower extremities) were treated with balloon angioplasty and/or stent placement. Follow-up included clinical examination, angiography, and color duplex ultrasound. Technical success was 100% (25/25) for stenoses and 50% (4/8) for occlusive lesions, representing all lesions combined from different anatomic locations. Dissection (n = 3) and arterial rupture with retroperitoneal hematoma (n = 1) was found in three patients. During follow-up (mean 12 months), restenoses (n = 8) and re-restenoses (n = 1) occurred in 8 vascular areas. Three of these lesions were treated with repeated PTA (n = 4). The cumulative primary clinical success rate was 67.6%, cumulative secondary success rate 74.4%, and cumulative tertiary success rate 75.9%. Interventional therapy in systemic vasculitis provides promising results in technical success rates and followup. Angioplasty may result in arterial injury, but the rate of complications is low.
Cardiovasc Intervent Radiol
PMID:Percutaneous management of occlusive arterial disease associated with vasculitis: a single center experience. 1252 37

A 66-year-old woman was diagnosed with severe aortic regurgitation. Blood studies constantly showed positive C-reactive protein. Aortic valve replacement using a mechanical valve was carried out. Four months after the operation, echocardiogram showed aortic regurgitation due to paravalvular leakage. Reoperation was performed using a stentless aortic root bioprosthesis. The pathological specimen from the aortic wall was consistent with giant cell arteritis. The patient was treated with prednisone with dramatic improvement of systemic symptoms.
Jpn J Thorac Cardiovasc Surg 2003 Sep
PMID:Aortic root replacement with a stentless bioprosthesis in a patient with giant cell arteritis. 1452 71


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