[一名58岁患有颞部头痛、颌部间歇性运动障碍及B症状的患者]
[A 58-year-old patient with temporal headache, jaw claudication and B symptoms].
作者信息
Gehlen M, Schwarz-Eywill M, Schäfer N, Pfeiffer A, Woenkhaus J, Bräsen J H
机构信息
Klinik für Innere Medizin, Rheumatologie und Immunologie, Evangelisches Krankenhaus Oldenburg, Medizinischer Campus der Universität Oldenburg, European Medical School Oldenburg/ Groningen, Oldenburg, Deutschland,
出版信息
Z Rheumatol. 2015 May;74(4):359-62. doi: 10.1007/s00393-014-1551-4.
CASE REPORT
We report the case of a patient with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis with involvement of the temporal artery, presenting with clinical manifestations of giant cell arteritis and temporal arteritis, such as temporal headache, jaw claudication, weight loss, night sweats and increased inflammatory parameters. The ultrasound scan showed a typical halo sign of the temporal artery.
DIAGNOSTICS
In the case of further atypical organ symptoms, e.g. hematuria and proteinuria, detailed differential diagnostic investigations are essential to clarify the situation. Histological findings from the affected organs play a decisive role.
CONCLUSION
An involvement of the temporal artery due to ANCA-associated vasculitis is extremely rare and may mimic giant cell arteritis. The exact diagnosis of ANCA-associated vasculitis is, however, important because this leads to a different approach concerning therapy and prognosis.
病例报告
我们报告了一例抗中性粒细胞胞浆抗体（ANCA）相关性血管炎累及颞动脉的病例，该患者表现出巨细胞动脉炎和颞动脉炎的临床表现，如颞部头痛、颌部间歇性运动障碍、体重减轻、盗汗以及炎症指标升高。超声扫描显示颞动脉有典型的晕征。
诊断
对于出现进一步非典型器官症状（如血尿和蛋白尿）的情况，详细的鉴别诊断检查对于明确病情至关重要。受累器官的组织学检查结果起决定性作用。
结论
ANCA相关性血管炎累及颞动脉极为罕见，可能类似巨细胞动脉炎。然而，ANCA相关性血管炎的确切诊断很重要，因为这会导致治疗方法和预后有所不同。
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