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

A 61-year-old woman with Addison's disease and malignant lymphoma for several years was admitted to hospital with a 2-month history of fatigue and a 7 kg weight loss. The erythrocyte sedimentation rate was 92 mm h-1 and a temporal biopsy was performed as a part of the clinical investigation. She suddenly suffered a paresis of the right arm, sudden blindness and her blood pressure fell to 100/60 mmHg. Hydrocortisone was given intravenously followed by betamethasone, and an Addison crisis as well as a giant cell arteritis (GCA) was suspected. Activity in the malignant lymphoma was also a possibility. The patient did not improve and died 8 d later. The temporal biopsy indicated GCA. The autopsy showed a pronounced intimal inflammatory reaction of the intracerebral arteries and an infarction in the left posterior hemisphere. A possible link between GCA and other autoimmune diseases is discussed.
J Intern Med 1989 Sep
PMID:Addison's disease, malignant lymphoma and death from cerebral giant cell arteritis. 279 51

The treatment of polymyalgia rheumatica (PMR) and temporal arteritis (TA) is still controversial. To assess the influence on the course of these diseases of the clinical symptoms at initial presentation and of the starting dosage of corticosteroid (CS) treatment the data for 210 patients, who were diagnosed as having PMR or TA from 1976 to 1986 and were followed up closely, were reviewed. One hundred and thirty two patients were diagnosed as having 'clinically pure' PMR; prednisone starting doses of over 15 mg daily provided more CS related adverse effects without any advantage. The mean duration of treatment was 25.7 months. Nine patients later developed symptoms of TA, and there were no predictive features for this. None experienced visual or neurological complications. Seventy eight patients were diagnosed as having clinical TA. Twenty five patients treated with low starting doses of prednisone, ranging from 10 to 20 mg/d (mean 16.2 mg/d), developed less CS related adverse effects and did not have more visual or neurological complications than 53 patients treated with higher doses. The mean duration of treatment was 30.9 months. Fifteen patients experienced visual or neurological complications and men (10/30) developed these complications more frequently than women (5/48) (p less than 0.02). These results suggest that (a) clinically pure PMR is a benign disease requiring low doses of CS treatment; (b) low doses of CS seem an adequate treatment for most cases of TA; (c) a worse prognosis seems attached to the male sex in TA.
Ann Rheum Dis 1988 Sep
PMID:Polymyalgia rheumatica and temporal arteritis: a retrospective analysis of prognostic features and different corticosteroid regimens (11 year survey of 210 patients). 317 14

33 patients suffering from temporal arteriitis (Morbus Horton) were investigated noninvasively by Oculo-Oscillo-Dynamography (OODG), Orbita-Dynamography (ODG) and Temporalis-Dynamography (TDG). The ocular, orbital and temporal oscillograms and oscillodynamograms revealed characteristic and unmistakable alterations; i.e., striking reduction of the pulse volumes and a decrease of the blood pressures in the respective circulatory regions as a result of a stenosing and occluding vascular process. The 3 methods yielded typical patterns of the occluding process, which led to the conclusion that in untreated persons the stenosing process of the arteritis cranialis tends to start in the vascular branches of the external carotid artery and subsequently includes branches of the internal carotid system, such as the ophthalmic artery. High doses of prednisolone resulted in reopening of the vessels that had been stenosed and occluded by arteritis, and in most cases restored normal circulation in the regions examined within several weeks or months. From the investigations made on 66 eyes of the 33 patients, the authors conclude that combined use of OODG, ODG, and TDG makes it possible to diagnose temporal arteritis with a high degree of certainty. In all 33 cases the disease was diagnosed with OODG, ODG and TDG and confirmed histologically. Since the OODG, ODG, TDG examinations are well tolerated by the patient and can be repeated at any time, it is suggested to employ them for the supervision of therapy as well to detect any possible relapse of the inflammatory occluding vascular process.
Z Gesamte Inn Med 1988 Sep 15
PMID:[Temporal arteritis--diagnosis and therapeutic control]. 320 6

Close examination of a series of temporal artery biopsy specimens provided histologic and statistical evidence that any association between the occurrence of giant cell arteritis and senile amyloidosis of the temporal artery internal elastic lamina is not direct, but is associated incidentally with old age. Substantial demographic differences between the 2 conditions were found; the prevalence of giant cell arteritis first waxed and then waned with increasing age, while rates for senile amyloidosis of the temporal artery progressed steadily toward 100% in the ninth decade of life.
Arthritis Rheum 1988 Sep
PMID:Giant cell inflammation compared with amyloidosis of the internal elastic lamina in temporal arteries. 342 16

This report describes a case of aneurysm of the ascending aorta with secondary, severe, aortic valve incompetence following temporal arteritis in a sixty-five-year-old woman.
Angiology 1987 Sep
PMID:Giant-cell arteritis causing severe aortic regurgitation secondary to aneurysm of the ascending aorta--a case report. 366 10

Serious ocular and systemic complications may result from inflammatory processes of the orbit. Temporal arteritis is one such process that can affect the eye. The patient described herein is unusual because she presented initially with signs and symptoms similar to orbital cellulitis. As her disease evolved, she displayed marked, hemorrhagic chemosis with some limitation of abduction and resistance to retropulsion on the involved side. Laboratory and radiologic findings eliminated orbital cellulitis, limited Wegener's granulomatosis, and other systemic inflammatory disorders and led to the diagnosis of temporal arteritis. To our knowledge, this complex of presenting signs has not been previously reported.
Ann Ophthalmol 1987 Sep
PMID:An unusual presentation of temporal arteritis. 366 21

Cutaneous involvement in giant cell arteritis is quite uncommon. A patient is described who presented with pretibial skin lesions clinically indistinguishable from erythema nodosum which, on biopsy, showed subcutaneous pannicular giant cell vasculitis. Cutaneous manifestations of giant cell arteritis are subsequently reviewed.
Ann Rheum Dis 1987 Sep
PMID:Giant cell arteritis of the skin simulating erythema nodosum. 367 13

Extracranial giant cell arteritis occurs in 10% to 15% of patients with temporal arteritis and polymyalgia rheumatica. Aorta and its major branches are most often involved and death may result from an unsuspected ruptured aortic aneurysm or aortic dissection. Involvement of coronary arteries by giant cell arteritis resulting in death from myocardial infarction is extremely rare. This article describes one such case: an 84-year-old man who died of acute myocardial infarction with the unexpected autopsy finding of giant cell aortitis and coronary arteritis, and who, three years earlier, had sudden onset of bilateral blindness and biopsy-proven temporal arteritis.
Arch Pathol Lab Med 1986 Sep
PMID:Temporal arteritis with giant cell aortitis, coronary arteritis, and myocardial infarction. 375 98

The duration of therapy and outcome were examined in 76 patients with polymyalgia rheumatica without evidence of temporal arteritis at presentation. Seventy-five patients received corticosteroids, with a mean prednisone dosage of 22.8 mg per day initially. Duration of therapy was assessed using life-table methods. No significant difference could be ascertained between groups segregated on the basis of age, sex, or initial steroid dosage. The median duration of therapy was 37.3 months. It was estimated that 40 percent of patients will require therapy longer than four years. Corticosteroids were permanently discontinued in 31 patients after a mean of 23.7 months of therapy. The data support the concept of two patient populations--one with limited disease and another requiring long-term therapy. Relapses were frequent, occurring in 56 percent of patients. Evolution of arteritis during the course of therapy was infrequent, occurring in only one patient. Steroid-related adverse effects occurred in 22.7 percent of patients and were more common in females. The data suggest that, although corticosteroids may be discontinued in some patients with polymyalgia rheumatica, prolonged therapy is required in a significant number.
Am J Med 1985 Sep
PMID:Polymyalgia rheumatica. Duration of therapy and long-term outcome. 403 82

A patient with active giant cell arteritis developed paraparesis and dissociated sensory loss due to infarction in the anterior spinal artery territory at the level of T12. Three days later fatal basilar artery thrombosis occurred. No occlusive lesion was found to explain the anterior spinal artery syndrome but this was associated with active arteritis. Alternative possibilities are that thrombus was present in involved cervical feeding vessels, or that emboli arose from intimal involvement in larger vessels, or that the event was related to thrombocytosis.
J Neurol Neurosurg Psychiatry 1985 Sep
PMID:Giant cell arteritis with spinal cord infarction and basilar artery thrombosis. 404 90


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