Addison's disease, malignant lymphoma and death from cerebral giant cell arteritis.
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.
Landin
K
K
Department of Medicine II, Sahlgrenska Hospital, Gothenburg, Sweden.
Bengtsson
B A
BA
Wilhelmsen
L
L
D000224:Addison Disease / Q000150:complications*; D002536:Cerebral Arteries / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008223:Lymphoma / Q000150:complications*; D008875:Middle Aged