Krug S, Portig I, Librizzi D, Pfestroff A, Gress T, Michl P
Klinik für Gastroenterologie, Endokrinologie und Stoffwechsel, Philipps-Universität Marburg, Baldingerstr. 1, 35043, Marburg.
Internist (Berl). 2013 Feb;54(2):249-53. doi: 10.1007/s00108-012-3223-2.
A 79-year-old patient presented with weight loss, subfebrile body temperature and unclear jaw pain. After ruling out malignant and infectious causes, positron emission tomography-computed tomography (PET-CT) revealed markedly elevated glucose utilization of the large thoracic and upper limb arteries, suggesting systemic vasculitis. Color-coded duplex sonography confirmed thickening of the wall of the external carotid artery consistent with vasculitis. The patient was diagnosed with giant cell arteritis involving the large thoracic arteries and the upper limb arteries but without involvement of the superficial temporal artery. Based on the involvement of the external carotid artery, the jaw pain could be classified as jaw claudication. Clinical and laboratory remission was achieved with systemic glucocorticoids which could subsequently be tapered. The patient is well and asymptomatic 12 months after diagnosis and 2 months without steroids.
一名79岁患者出现体重减轻、低热及不明原因的颌部疼痛。排除恶性及感染性病因后，正电子发射断层扫描-计算机断层扫描（PET-CT）显示胸段大动脉及上肢动脉葡萄糖利用显著升高，提示系统性血管炎。彩色编码双功能超声检查证实颈外动脉壁增厚，符合血管炎表现。该患者被诊断为累及胸段大动脉及上肢动脉的巨细胞动脉炎，但未累及颞浅动脉。基于颈外动脉受累情况，颌部疼痛可归类为颌跛行。全身应用糖皮质激素后实现了临床及实验室缓解，随后可逐渐减量。诊断后12个月且停用类固醇2个月时，患者情况良好且无症状。
