[Aortic involvement in patients with temporal arteritis and polymyalgia rheumatica].
In 4 patients with temporal arteritis or polymyalgia rheumatica, women aged 60, 57, 83 and 73 years respectively, signs of aortic involvement were established. The first patient presented with signs of systemic inflammation without signs of temporal arteritis or aortitis. In the second, an acute symptomatic thoracoabdominal aneurysm developed. In the third, temporal arteritis was associated with chronic progressive dilatation ofthe thoracic aorta. The fourth developed signs of intermittent claudication of the extremities. The clinical manifestations in all patients were attributed to chronic inflammation of the aorta caused by giant cell arteritis. Aortic giant cell arteritis frequently accompanies temporal arteritis, but is rarely diagnosed. Up to 75% of patients with temporal arteritis may have some degree of aortic involvement. Thoracic aneurysms, complicated by rupture or dissection, are the most serious complications. Aortic disease associated with signs of systemic inflammation should trigger the suspicion of giant cell arteritis. Corticosteroids are the most important part of treatment. Three patients recovered following treatment; the first two received an endoprosthesis; in the woman aged 83 years, this was not technically possible; she died after 1.5 years.
Honing
M L H
ML
VU Medisch Centrum, De Boelelaan 1117, 1081 HV Amsterdam.
Bredie
S J H
SJ
Smulders
Y M
YM
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D001807:Blood Vessel Prosthesis; D017809:Fatal Outcome; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy / Q000209:etiology*; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D012307:Risk Factors; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones