From the *Department of Internal Medicine and †Division of Rheumatology, University of Kentucky, Lexington, KY.
J Clin Rheumatol. 2013 Oct;19(7):405-6. doi: 10.1097/RHU.0b013e3182a701e8.
Giant cell arteritis (GCA) is an autoimmune disorder characterized by the inflammation of medium to large vessels. Although classic descriptions have centered on features such as vision loss, headaches, fevers, and jaw claudication, there is increasing recognition of more atypical manifestations. We report a case of GCA in a 77-year-old male patient initially presenting with depressed mood and headache. His psychiatric symptoms promptly responded to treatment with corticosteroids without the use of antidepressants. This case adds to the literature that GCA may initially present with affective or psychotic symptoms and highlights the need for clinicians to consider GCA in the differential diagnosis for new-onset psychiatric disorders in the elderly.
巨细胞动脉炎(GCA)是一种自身免疫性疾病,其特征为中等至大血管的炎症。尽管经典描述主要集中在视力丧失、头痛、发热和下颌跛行等特征上,但人们越来越认识到更多不典型的表现。我们报告了一例 77 岁男性患者的 GCA 病例,最初表现为情绪低落和头痛。他的精神症状在皮质类固醇治疗下迅速得到缓解,而无需使用抗抑郁药。该病例增加了文献记载,即 GCA 最初可能表现为情感或精神病症状,并强调了临床医生在老年新发精神障碍的鉴别诊断中考虑 GCA 的必要性。