Pacella Fernanda, Mazzeo Francesco, Giorgi Dario, Cerutti Francesco, Impallara David, Cuozzo Giovanni, Soldini Maurizio, Pacella Elena
Department of Ophthalmology, Sapienza University, Rome, Italy.
Clin Ophthalmol. 2012;6:909-13. doi: 10.2147/OPTH.S24572. Epub 2012 Jun 13.
This article describes the case of a 68-year-old patient suffering from giant cell arteritis (also known as Horton's arteritis or temporal arteritis). The patient came to our attention due to a large and sudden visual loss caused by the occlusion of major retinal arteries. The patient had neuralgic pain in the face. The next day, for a thorough examination, the patient went to the day hospital with a further worsening of the visual loss which required immediate admission to the ophthalmological ward for hospitalization lasting 10 days. During the observation period it was difficult to make an instant diagnosis due to the absence of clinical signs or diagnostic tests for Horton's arteritis. Only after the third day of hospitalization, when corticosteroid therapy was undertaken following the appearance of significant systemic symptoms, did the patient begin to show a gradual improvement in overall clinical status. The case highlights the difficulty in making a rapid diagnosis of giant cell arteritis and the efficacy of early steroid therapy in this vascular autoimmune disease that otherwise may result in irreversible functional and debilitating systemic damage.
本文描述了一名68岁患有巨细胞动脉炎(也称为霍顿动脉炎或颞动脉炎)患者的病例。该患者因主要视网膜动脉阻塞导致突然严重视力丧失而引起我们的注意。患者面部有神经痛。第二天,为了进行全面检查,患者前往日间医院,此时视力丧失进一步恶化,需要立即入住眼科病房住院10天。在观察期内,由于缺乏巨细胞动脉炎的临床体征或诊断测试,很难做出即时诊断。仅在住院第三天,在出现明显全身症状后开始进行皮质类固醇治疗后,患者的整体临床状况才开始逐渐改善。该病例凸显了快速诊断巨细胞动脉炎的困难,以及早期类固醇治疗在这种血管自身免疫性疾病中的疗效,否则这种疾病可能会导致不可逆的功能和使人衰弱的全身损害。