N Engl J Med. 2014 Jul 3;371(1):50-7. doi: 10.1056/NEJMcp1214825.
A 79-year-old woman presents with new-onset pain in her neck and both shoulders. She takes 7.5 mg of prednisone per day for giant-cell arteritis. Occipital tenderness and diplopia developed 11 months before presentation. At that time, her erythrocyte sedimentation rate was elevated, at 78 mm per hour, and a temporal-artery biopsy revealed granulomatous arteritis. The diplopia resolved after 6 days of treatment with 60 mg of prednisone daily. Neither headache nor visual symptoms developed when the glucocorticoids were tapered. How should this patient’s care be managed?
一位 79 岁女性出现新发颈部和双肩疼痛。她因巨细胞动脉炎每天服用 7.5 毫克泼尼松。在就诊前 11 个月，出现枕部压痛和复视。当时，她的红细胞沉降率升高，为 78 毫米/小时，颞动脉活检显示肉芽肿性动脉炎。在每天接受 60 毫克泼尼松治疗 6 天后，复视得到缓解。在糖皮质激素减量时，既没有出现头痛也没有出现视觉症状。应该如何管理该患者的治疗？
