Wu Chien-Sheng, Hsu Kwan-Lih, Chang Yih-Leong, Lee Kuang-Lun
Department of Internal Medicine, Far East Memorial Hospital, Taipei, Taiwan, ROC.
J Microbiol Immunol Infect. 2004 Aug;37(4):246-9.
Giant cell arteritis is rarely reported in people aged less than 50 years. We report a case of giant cell arteritis in a woman who developed symptoms of dizziness, headache, bilateral sensorineural hearing impairment, and had 1 episode of transient left hemiparesis before the age of 30. Carotid angiography showed multiple segmental narrowing in cranial vessels. Subsequently, at the age of 31, she had weight loss and developed a fever. Chest radiograph revealed mediastinal widening, and chest computed tomography revealed dilated pulmonary arteries and veins. Coronary angiography and aortography showed irregular narrowing of the descending aorta and multiple stenosis, with aneurysmal dilatation involving the proximal and distal coronary, pulmonary and mesenteric arteries. Multinucleated giant cells and predominant CD8+ T lymphocyte infiltration were noted in a left temporal artery biopsy specimen. The patient's age and the finding of dilated pulmonary veins and prominent CD8+ T lymphocytes in the biopsy specimen suggest that this case was a distinct form of systemic giant cell arteritis.
巨细胞动脉炎在50岁以下人群中鲜有报道。我们报告一例巨细胞动脉炎女性病例，该患者在30岁前出现头晕、头痛、双侧感音神经性听力减退症状，并发生过1次短暂性左半身轻瘫。颈动脉血管造影显示颅内血管多处节段性狭窄。随后，在31岁时，她体重减轻并出现发热。胸部X线片显示纵隔增宽，胸部计算机断层扫描显示肺动脉和肺静脉扩张。冠状动脉造影和主动脉造影显示降主动脉不规则狭窄及多处狭窄，近端和远端冠状动脉、肺动脉和肠系膜动脉有动脉瘤样扩张。左颞动脉活检标本中可见多核巨细胞和主要的CD8+T淋巴细胞浸润。患者的年龄以及活检标本中肺静脉扩张和显著的CD8+T淋巴细胞这一发现表明，该病例是系统性巨细胞动脉炎的一种独特形式。
