Rheumatology Division, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Clinics (Sao Paulo). 2013;68(3):317-22. doi: 10.6061/clinics/2013(03)oa06.
To describe demographic features, disease manifestations and therapy in patients with giant cell arteritis from referral centers in Brazil.
A retrospective cohort study was performed on 45 giant cell arteritis patients from three university hospitals in Brazil. Diagnoses were based on the American College of Rheumatology classification criteria for giant cell arteritis or temporal artery biopsy findings.
Most patients were Caucasian, and females were slightly more predominant. The frequencies of disease manifestations were as follows: temporal headache in 82.2%, neuro-ophthalmologic manifestations in 68.9%, jaw claudication in 48.9%, systemic symptoms in 44.4%, polymyalgia rheumatica in 35.6% and extra-cranial vessel involvement in 17.8% of cases. Aortic aneurysms were observed in 6.6% of patients. A comparison between patients with biopsy-proven giant cell arteritis and those without temporal artery biopsies did not yield significant differences in disease manifestations. All patients were treated with oral prednisone, and intravenous methylprednisolone was administered to nearly half of the patients. Methotrexate was the most commonly used immunosuppressive agent, and low-dose aspirin was prescribed to the majority of patients. Relapses occurred in 28.9% of patients, and aspirin had a protective effect against relapses. Females had higher prevalences of polymyalgia rheumatica, systemic manifestations and jaw claudication, while permanent visual loss was more prevalent in men.
Most of the clinical features of Brazilian giant cell arteritis patients were similar to those found in other studies, except for the high prevalence of neuro-ophthalmic manifestations and permanent blindness in the Brazilian patients. Aspirin had a protective effect on relapses.
描述巴西转诊中心的巨细胞动脉炎患者的人口统计学特征、疾病表现和治疗方法。
对来自巴西三所大学医院的 45 例巨细胞动脉炎患者进行了回顾性队列研究。诊断基于美国风湿病学会（ACR）巨细胞动脉炎分类标准或颞动脉活检结果。
大多数患者为白种人，女性略占优势。疾病表现的频率如下：颞动脉性头痛 82.2%，神经眼科表现 68.9%，下颌跛行 48.9%，全身症状 44.4%，风湿性多肌痛 35.6%，颅外血管受累 17.8%。6.6%的患者存在主动脉瘤。活检证实的巨细胞动脉炎患者与未行颞动脉活检的患者之间的疾病表现比较无显著差异。所有患者均接受口服泼尼松治疗，近一半患者接受静脉注射甲基泼尼松龙治疗。甲氨蝶呤是最常用的免疫抑制剂，大多数患者均接受小剂量阿司匹林治疗。28.9%的患者复发，阿司匹林对复发有保护作用。女性更易出现风湿性多肌痛、全身表现和下颌跛行，而男性更易出现永久性视力丧失。
巴西巨细胞动脉炎患者的大多数临床特征与其他研究相似，但巴西患者的神经眼科表现和永久性失明更为常见。阿司匹林对复发有保护作用。
