Vasculitis Clinic, Mount Sinai Hospital, University of Toronto, 60 Murray Street, 2nd Floor, Room 222, Toronto, Ontario, M5T 3L9, Canada.
Joint Bone Spine. 2013 May;80(3):324-7. doi: 10.1016/j.jbspin.2012.09.012. Epub 2012 Nov 9.
Temporal arteritis in the form of giant cell arteritis (GCA) is common in the elderly but is extremely rare in patients less than 50 years of age. We describe two male patients: one who presented at the age of 31 years with painful, nodular swellings of both temporal arteries and whose temporal artery biopsy demonstrated a non-giant cell panarteritis with mixed inflammatory cell infiltrate typical of juvenile temporal arteritis (JTA); another one, aged 40 years, who presented with headache and cerebral angiography consistent with an intracranial vasculitis and whose temporal artery biopsy confirmed an authentic multinucleated GCA. The first patient spontaneously improved after biopsy and the second patient has responded well to corticosteroid therapy. These two cases exemplify well two distinct but extremely rare forms of temporal arteritis in young patients. A 3rd subset is that associated with a systemic vasculitis. Few cases of JTA have been reported and, to our knowledge, we describe in this report one of the only cases of GCA with central nervous system involvement in the young.
巨细胞动脉炎(GCA)形式的颞动脉炎在老年人中很常见,但在年龄小于 50 岁的患者中极为罕见。我们描述了两名男性患者:一名患者在 31 岁时出现双侧颞动脉疼痛性结节性肿胀,其颞动脉活检显示非巨细胞全层动脉炎,伴有典型的幼年型颞动脉炎(JTA)的混合炎症细胞浸润;另一名患者年龄为 40 岁,表现为头痛和符合颅内血管炎的脑血管造影,其颞动脉活检证实为真正的多核 GCA。第一个患者在活检后自发改善,第二个患者对皮质类固醇治疗反应良好。这两个病例很好地说明了两种截然不同但在年轻患者中极为罕见的颞动脉炎形式。第三个亚组与系统性血管炎有关。JTA 的病例很少报道,据我们所知,我们在本报告中描述了年轻患者中唯一一例伴有中枢神经系统受累的 GCA 病例。