Fayyaz Beenish
Internal Medicine, Greater Baltimore Medical Center, Towson, MD, USA.
J Community Hosp Intern Med Perspect. 2018 Jun 12;8(3):134-137. doi: 10.1080/20009666.2018.1458571. eCollection 2018.
Carotid atherosclerosis and giant cell arteritis (GCA) are two distinct medical conditions with an overlapping clinical spectrum of vascular symptoms such as vision loss and ischemic stroke. This is because both diseases cause arterial ischemia with a predilection for carotid vasculature. In addition, high-vascular risk individuals who are diagnosed with GCA are usually elderly with age >55 years with high-vascular risk and thus can have underlying atherosclerosis. All these factors can pose a diagnostic dilemma for the physicians as GCA is a medical emergency which if left untreated can result in significant morbidity and mortality. Thus, it is important to avoid attributing occlusive arterial disease in elderly patients to atherosclerosis alone because some may have GCA. We present a case report in which presence of diffuse atherosclerosis was a major pitfall while making a timely diagnosis of GCA.
颈动脉粥样硬化和巨细胞动脉炎（GCA）是两种不同的疾病，它们在血管症状的临床谱上有重叠，如视力丧失和缺血性中风。这是因为这两种疾病都会导致动脉缺血，且倾向于累及颈动脉血管系统。此外，被诊断为GCA的高血管风险个体通常是年龄大于55岁的老年人，具有高血管风险，因此可能存在潜在的动脉粥样硬化。所有这些因素都可能给医生带来诊断难题，因为GCA是一种医疗急症，如果不及时治疗可能导致严重的发病率和死亡率。因此，重要的是避免将老年患者的闭塞性动脉疾病仅归因于动脉粥样硬化，因为有些患者可能患有GCA。我们报告一例病例，其中弥漫性动脉粥样硬化的存在是及时诊断GCA的一个主要陷阱。
