[Simple Horton's syndrome: modalities of treatment].
Corticosteroids remain the basis of treatment of Horton's syndrome, with prednisone the molecule of choice, since they improve the symptoms and considerably reduce the risk of blindness. Several clinical forms of the disease must be distinguished in order to specify the modalities of corticosteroid treatment and any eventual associated treatments. SIMPLE HORTON'S SYNDROME: The simple forms of the disease are defined by the absence of ocular involvement, the absence of clinical involvement of the large arteries, the absence of corticosteroid resistance and the absence of corticosteroid dependence (simple forms subsequently complicated). MODALITIES OF CORTICOSTEROID THERAPY: These simple forms justify an attack treatment with 0.7 mg/kg/d of prednisone although cortisone assaults do not have a specific justification. Initiation with lower daily doses of prednisone at 0.5/mg/kg or even less appear to expose the patient to a higher risk of progression of the disease, but merit assessment. SATELLITE QUESTIONS: The iatrogeneity of corticosteroids raises problems in corticosteroid dependent patients and those receiving prolonged attack treatment. The risk of cortisone-induced osteoporosis is particularly high during Horton's syndrome. There is still no prospective study specifying the indications for treatment of the disease with anticoagulants or platelet antiaggregants.
Agard
Christian
C
Service de médecine interne B, Hôpital Hôtel-Dieu, CHU Nantes, Place Alexis-Ricordeau, 44096 Nantes Cedex 01. christian.agard @chu-nantes.fr
Barrier
Jacques Henri
JH
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D013700:Giant Cell Arteritis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D010024:Osteoporosis / Q000139:chemically induced; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D012720:Severity of Illness Index
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D011241:Prednisone