de Gennes C, Le Thi Huong D, Wechsler B, Bercy J, Foncin J F, Piette J C, Godeau P
Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
J Rheumatol. 1989 Jan;16(1):130-2.
An 80-year-old white man presented with gangrenous lesions involving several distal phalanges of his left hand and an elevated erythrocyte sedimentation rate (ESR). Temporal artery biopsy showed patchy destruction of the internal elastic lamina by mononuclear cell infiltration, consistent with the diagnosis of temporal arteritis. After amputation of gangrenous lesions, he was discharged taking prednisone (60 mg/day). Twelve months after discharge there was no recurrence of ischemic manifestations and ESR was normal. Association of digital gangrene and elevated ESR should alert the clinician toward this diagnosis once other diseases such as atherosclerosis, scleroderma, lupus erythematosus, periarteritis nodosa have been ruled out.
一名80岁白人男性因左手多个远端指骨出现坏疽性病变且红细胞沉降率（ESR）升高前来就诊。颞动脉活检显示内弹力层有单核细胞浸润导致的片状破坏，符合颞动脉炎的诊断。坏疽性病变截肢后，他出院时服用泼尼松（60毫克/天）。出院12个月后，缺血表现未复发且ESR正常。一旦排除动脉粥样硬化、硬皮病、红斑狼疮、结节性多动脉炎等其他疾病，手指坏疽与ESR升高的关联应提醒临床医生考虑这一诊断。
