Genereau T, Herson S, Piette J C, Coutellier A, Pelletier S, Wechsler B, Bletry O, Renou P, Godeau P
Service de Médecine Interne de la Salpêtrière, Groupe Hospitalier Pitié-Salpêtrière, Paris.
Ann Med Interne (Paris). 1992;143(5):303-8.
Six young-adult patients (19- to 32-years-old) are described: 3 men with temporally localized systemic vasculitis (thromboangiitis obliterans 2, Churg-Strauss angiitis 1) and 3 patients (2 men, 1 woman) with isolated temporal arteritis. Temporal arteritis in subjects under 40 years of age consists of either a temporal localization of systemic vasculitis (thromboangiitis obliterans or Buerger's disease, Churg-Strauss angiitis or polyarteritis nodosa) or a distinct entity of which only 12 biopsy-proven cases have been reported to date. The latter is differentiated from temporal (giant cell) arteritis of the older patient by a higher incidence in men, and the absence or rarity of general symptoms, ocular complications and an accelerated erythrocyte sedimentation rate. Two types of temporal arteritides in young adults seem to be distinguishable: an asymptomatic form with an isolated temporal nodule and a more symptomatic one. In some cases, temporal arteritis in young adults corresponds to a unique entity "juvenile temporal arteritis", which seems to be different from Takayasu's arteritis, localized forms of polyarteritis nodosa and Kimura's disease. Although its treatment remains difficult to define, therapy of the symptomatic form could include steroids, whereas the asymptomatic one seems to require only simple monitoring.
本文描述了6例青年患者(年龄在19至32岁之间):3例男性患有局限性系统性血管炎(血栓闭塞性脉管炎2例,变应性肉芽肿性血管炎1例),3例患者(2例男性,1例女性)患有孤立性颞动脉炎。40岁以下患者的颞动脉炎包括系统性血管炎的颞部局限性病变(血栓闭塞性脉管炎或伯格氏病、变应性肉芽肿性血管炎或结节性多动脉炎)或一种独特的疾病实体,迄今为止仅报告了12例经活检证实的病例。后者与老年患者的颞(巨细胞)动脉炎的区别在于男性发病率较高,且缺乏或罕见全身症状、眼部并发症和血沉加快。青年成人的颞动脉炎似乎可分为两种类型:一种是无症状型,表现为孤立的颞部结节;另一种是症状较明显型。在某些情况下,青年成人的颞动脉炎相当于一种独特的疾病实体“青少年颞动脉炎”,它似乎不同于高安动脉炎、结节性多动脉炎的局限性形式和木村病。尽管其治疗方法仍难以确定,但症状较明显型的治疗可能包括使用类固醇,而无症状型似乎仅需进行简单监测。