title: [Diagnosis ex juvantibus-- an observation on giant cell arteritis].
abstract: On the basis of some cases of presumable giant cell arteritis, which were diagnosed and treated in a nursing home, the polymorphous character of this affection is emphasized. The author poses that biopsies of the temporal artery--certainly with elderly people--shouldn't be regarded as an absolute necessity and he refers in this context to the discussion held about it in the Dutch Magazine of Medicine (Nederlands Tijdschrift voor Geneeskunde, 126, 1982, 14, p. 636-637). It is remarkable in this discussion that advocates of the possibly even double-sided temporal biopsies (!) refer to the criteria of the Mayo Clinics (1978), which on further consideration, don't seem to be quite sound and, to say the least of it, don't very much take into account the localization of the arterial lesions outside the well-known ones. Several other authors appear to take full account of the variant and masked forms and have their doubts about the efficiency of the temporal artery biopsy. Where giant cell arteritis concerns mostly elderly people and the geriatric approach and solution of this and other medical problems in general sometimes are contrary to the current 'formal-clinical' attitude, the author thought it right to propose an alternative for the elderly advances in years: the trial of steroid therapy, keeping a conscientious control on the clinical picture and the biochemical symptoms.
mesh_terms: D000368:Aged; D001706:Biopsy; D001799:Blood Sedimentation; D005260:Female; D013700:Giant Cell Arteritis / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D011241:Prednisone / Q000627:therapeutic use*; D013699:Temporal Arteries / Q000473:pathology*
chemical_list: D011241:Prednisone
vernacular_title: Diagnosestelling ex juvantibus-- beschouwing over reuscel-arteriïtis.