Durant Cecile, Connault Jérome, Graveleau Julie, Toquet Claire, Brisseau Jean M, Hamidou Mohamed
Department of Internal Medecine, CHU Hôtel Dieu, Nantes, France.
Ann Vasc Surg. 2011 Apr;25(3):384.e5-7. doi: 10.1016/j.avsg.2010.10.006. Epub 2010 Dec 23.
Classic giant cell arteritis affects older adults who are aged >50 years. Temporal arteritis is uncommon in young adults but juvenile temporal vasculitis (JTV) is the most frequent form found in young people. Clinical presentation is usually poor, with localized temporal inflammatory changes without consistent systemic manifestations. Generally, the patients have a benign clinical course, without ophthalmic or ischemic manifestations. In these rare JTVs, excision of the involved section of temporal artery is often curative and corticosteroid therapy is not required.
The present study reports a case of JTV in a middle-aged woman.
A 44-year-old woman complained of violent temporal headache, with a slight inflammatory syndrome. She had no vascular systemic manifestation and no cause of secondary vasculitis. Doppler ultrasonography suggested a localized inflammatory arteritis. Temporal biopsy was performed. Histologic findings were compatible with JTV (nongranulomatous panarteritis with mononuclear cells and eosinophils). All the symptoms disappeared after excision. One year later, she remains well and reports neither systemic manifestation nor recurrence.
Vasculitis of the temporal arteries in young people is uncommon and JTV is rare in middle-aged people. It is necessary to search for systemic or secondary vasculitis. In contrast to giant cell arteritis, steroids are not required.
经典的巨细胞动脉炎影响年龄大于50岁的老年人。颞动脉炎在年轻人中不常见,但青少年颞动脉血管炎(JTV)是年轻人中最常见的形式。临床表现通常不佳,有局部颞部炎症改变但无一致的全身表现。一般来说,患者临床病程良性,无眼部或缺血表现。在这些罕见的JTV病例中,切除受累的颞动脉段通常可治愈,无需皮质类固醇治疗。
本研究报告了一例中年女性的JTV病例。
一名44岁女性主诉剧烈的颞部头痛,伴有轻微炎症综合征。她无血管系统表现,也无继发性血管炎病因。多普勒超声提示局部炎症性动脉炎。进行了颞动脉活检。组织学检查结果符合JTV(非肉芽肿性全动脉炎伴单核细胞和嗜酸性粒细胞)。切除术后所有症状消失。一年后,她情况良好,既无全身表现也无复发。
年轻人颞动脉血管炎不常见,中年人的JTV罕见。有必要查找全身性或继发性血管炎。与巨细胞动脉炎不同,无需使用类固醇。