Department of Rehabilitation Medicine, Astley Ainslie Hospital, Edinburgh, Scotland.
J Clin Rheumatol. 2010 Aug;16(5):225-8. doi: 10.1097/RHU.0b013e3181e9a338.
It is not established whether the increased risk of stroke in patients with giant cell arteritis (GCA) is because of atherosclerosis, persistent arterial inflammation, or an iatrogenic effect of corticosteroids. This creates difficulties in choosing the most appropriate treatment. We report 2 patients with GCA who developed repeated strokes involving different arterial territories following initiation of corticosteroid therapy, despite resolution of cranial symptoms and normalization of inflammatory markers. Subsequent investigation suggested persisting arteritis as the cause of these strokes. The cases revealed the limitations of laboratory tests or imaging techniques in determining the cause of stroke in recently diagnosed GCA. There is a need to develop effective means of monitoring GCA activity and to determine the most effective treatment approach in this circumstance.
巨细胞动脉炎（GCA）患者中风风险增加的原因是动脉粥样硬化、持续性动脉炎症还是皮质类固醇的医源性作用尚不清楚。这给选择最合适的治疗方法带来了困难。我们报告了 2 例 GCA 患者，尽管颅部症状缓解且炎症标志物恢复正常，但在开始皮质类固醇治疗后，不同动脉区域仍反复发作中风。进一步的调查提示持续性动脉炎是这些中风的原因。这些病例揭示了实验室检查或影像学技术在确定近期诊断的 GCA 中风原因方面的局限性。需要开发有效的方法来监测 GCA 的活动，并确定在此情况下最有效的治疗方法。
