Cailleux N, Lévesque H, Borg J Y, Clavier E, Courtois H
Service de Médecine Interne, Angéiologie, Diabétologie, CHU Rouen-Boisguillaume.
J Mal Vasc. 1992;17(2):157-9.
Diffuse arterial involvement in temporal arteritis is well known but the intimate mechanisms of vasculopathy is unknown. Recently the presence of anticardiolipin antibodies (aCL) has been recognized in giant cell arteritis. We report two cases of temporal arteritis with diffuse arterial involvement associated with aCL (axillary arteries in the two cases associated with femoral arteries in one). During corticosteroid and anticoagulant therapy, a rapid improvement was noted with regression of upper-limb ischemia. One month later, the aCL were absent. These cases confirm the presence of aCL in giant cell arteritis with diffuse arterial involvement. These antibodies might imply severe vascular damage and could play a role in pathogenesis of the vasculopathy of temporal arteritis. Their presence suggests the necessity of anticoagulant therapy at the beginning of corticosteroid therapy.
颞动脉炎中动脉弥漫性受累是众所周知的,但血管病变的具体机制尚不清楚。最近,在巨细胞动脉炎中已认识到抗心磷脂抗体(aCL)的存在。我们报告了两例颞动脉炎伴动脉弥漫性受累且与aCL相关的病例(两例均累及腋动脉,其中一例还累及股动脉)。在使用皮质类固醇和抗凝治疗期间,上肢缺血症状迅速改善并消退。一个月后,aCL消失。这些病例证实了在伴有动脉弥漫性受累的巨细胞动脉炎中存在aCL。这些抗体可能意味着严重的血管损伤,并可能在颞动脉炎血管病变的发病机制中起作用。它们的存在提示在皮质类固醇治疗开始时进行抗凝治疗的必要性。