Ninet J, Bachet P, Bureau du Colombier P, Krahenbuhl B, Rousset H, Perpoint B, Pasquier J
Clinique médicale A, hôpital Edouard-Herriot, Lyon.
Arch Mal Coeur Vaiss. 1988 Jan;81(1):89-97.
Ten patients aged from 60 to 73 years presenting with Horton's disease or polymyalgia rheumatica had arteritis of the upper limbs. Asymptomatic abolition of pulse in the upper limbs (1 case) or claudication at rest or exercise (9 cases) and/or Raynaud's phenomenon (5 cases) preceded (4 cases) or accompanied (1 case) the discovery of giant cell arteritis, or complicated the reduction or discontinuation of corticosteroid therapy. Diagnosis rested on the regular association of an inflammatory syndrome with multiple arterial tapered stenoses and/or arterial thrombosis in the post-vertebral subclavian, axillary or brachial arteries and, chiefly, on the demonstration (in 7 cases) of a giant cell granuloma at biopsy of the temporal artery. Corticosteroid therapy (1 mg/kg/24 h in 8 cases and 0.5 mg/kg/24 h in 2 cases) initially combined with anticoagulants in 4 cases resulted in rapid regression of ischaemic and systemic signs in all patients, thus avoiding surgical revascularization of the upper limbs.
10例年龄在60至73岁之间、患有霍顿病或风湿性多肌痛的患者出现了上肢动脉炎。上肢无症状性脉搏消失（1例）或静息或运动时跛行（9例）和/或雷诺现象（5例）先于（4例）或伴随（1例）巨细胞动脉炎的发现，或使皮质类固醇治疗的减量或停药复杂化。诊断依据是炎症综合征与椎动脉后锁骨下、腋或肱动脉多处动脉逐渐变细狭窄和/或动脉血栓形成的规律性关联，主要依据是颞动脉活检显示巨细胞肉芽肿（7例）。皮质类固醇治疗（8例为1mg/kg/24小时，2例为0.5mg/kg/24小时）最初在4例中联合抗凝剂使用，使所有患者的缺血和全身症状迅速消退，从而避免了上肢的手术血管重建。
