[Wegener's granulomatosis disclosed by clinical symptoms of Horton's disease].
In a series of 60 patients with Wegener's granulomatosis, 2 had initially presented with clinical signs suggestive of temporal arteritis. One of these two patients was a 69-year old woman suffering from inflammatory pain in the shoulders, wrists and knees, myalgias in the lower limbs and intermittent jaw claudication. The other patient was a 60-year old man with febrile polyarthritis predominantly affecting the knees and shoulders, and hyperaesthesia of the scalp. In both cases biopsy of the temporal artery gave negative results. Corticosteroids provided a dramatic improvement, but a relapse corrected the diagnosis. Three similar cases have been reported, but only one had a histological lesion of the temporal artery. Cases of temporal arteritis associated with pulmonary granulomatosis raise the problem of classification with localized Wegener's disease. An initial presentation suggestive of temporal arteritis may hide other systemic diseases, notably rheumatoid arthritis, periarteritis nodosa or Chug and Strauss angitis; Wegener's granulomatosis must be added to this list.
Le Thi Huong
D u
Du
Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Wechsler
B
B
Merillon
H
H
Sauvaget
F
F
De Gennes
C
C
Piette
J C
JC
Godeau
P
P
D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis*; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis*; D006801:Humans; D008297:Male
Granulomatose de Wegener révélée par un tableau évocateur de maladie de Horton.