Al-Abdulla Nael A, Rismondo Vivian, Minkowski John S, Miller Neil R
Wilmer Eye Institute, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.
Am J Ophthalmol. 2002 Dec;134(6):912-4. doi: 10.1016/s0002-9394(02)01811-1.
To present a case of herpes zoster vasculitis presenting as giant cell arteritis.
Interventional case report.
A 77-year-old woman presented with sudden onset of diplopia associated with temple headaches and a previous history of herpes zoster ophthalmicus. A temporal artery biopsy was obtained and in-situ hybridization performed for herpes zoster DNA.
The patient presented with a bilateral internuclear ophthalmoplegia. Initial diagnostic evaluation, including erythrocyte sedimentation rate, C-reactive protein, and temporal artery biopsy, was consistent with giant cell arteritis. However, in-situ hybridization of the temporal artery specimen was positive for herpes zoster DNA.
Herpes zoster vasculitis may mimic giant cell arteritis and should be considered in the differential of any patient with presumed giant cell arteritis with suspicious findings, central nervous system involvement, or previous herpes zoster infection.
报告一例表现为巨细胞动脉炎的带状疱疹性血管炎病例。
介入性病例报告。
一名77岁女性，突发复视，伴有颞部头痛，既往有眼部带状疱疹病史。获取颞动脉活检标本，并进行带状疱疹DNA原位杂交检测。
患者表现为双侧核间性眼肌麻痹。初始诊断评估，包括红细胞沉降率、C反应蛋白和颞动脉活检，均与巨细胞动脉炎相符。然而，颞动脉标本的原位杂交检测显示带状疱疹DNA呈阳性。
带状疱疹性血管炎可能酷似巨细胞动脉炎，对于任何疑似巨细胞动脉炎且有可疑表现、中枢神经系统受累或既往有带状疱疹感染的患者，在鉴别诊断时均应考虑该病。
