Internal Medicine Residency Program, Hennepin Healthcare, Minneapolis, MN, USA.
Rheumatology Fellowship Program, University of Minnesota, Minneapolis, MN, USA.
Cleve Clin J Med. 2019 Jul;86(7):465-472. doi: 10.3949/ccjm.86a.18103.
Giant cell arteritis is a common systemic vasculitis that affects the elderly and has a variable clinical presentation. Physicians should be aware of its different clinical phenotypes so that they can recognize it early and promptly initiate glucocorticoids, the mainstay of therapy. Clinicians should also be familiar with the toxicity of glucocorticoids and how to manage adverse effects. Tocilizumab, an interleukin 6 receptor inhibitor, is emerging as a glucocorticoid-sparing treatment, though its long-term safety and efficacy are still under study.
巨细胞动脉炎是一种常见的系统性血管炎,影响老年人,临床表现多样。医生应该了解其不同的临床表型,以便及早识别并及时开始使用糖皮质激素,这是主要的治疗方法。临床医生还应熟悉糖皮质激素的毒性以及如何处理不良反应。白细胞介素 6 受体抑制剂托珠单抗作为一种糖皮质激素保留治疗方法正在出现,但它的长期安全性和疗效仍在研究中。