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同时出现胸腔积液和心包积液作为巨细胞动脉炎的首发临床表现:一例报告

Simultaneous Pleural and Pericardial Effusion as First Clinical Manifestations of Giant Cell Arteritis: A Case Report.

作者信息

Georgakopoulou Vasiliki E, Mermigkis Dimitrios, Kairi Ourania, Garmpi Anna, Tsiafaki Xanthi

机构信息

Pulmonology Department, Laiko General Hospital, Athens, GRC.

1st Pulmonology Department, Sismanogleio Hospital, Athens, GRC.

出版信息

Cureus. 2020 Aug 31;12(8):e10163. doi: 10.7759/cureus.10163.

Abstract

Giant cell arteritis (GCA) is a chronic granulomatous vasculitis of unknown aetiology occurring in the older patients and affecting mostly the cranial branches of the arteries originating from the aortic arch. GCA is associated with polymyalgia rheumatica (PMR). Clinical features of the disorder include headache, scalp tenderness, jaw claudication, temporal artery abnormalities on physical examination, vision changes, and symptoms associated to PMR. Systemic manifestations include fever, anorexia and weight loss while less rare manifestations are related to the nervous system, the respiratory system, the pericardium and extra-cranial large vessels. Here we report a rare case of simultaneous pleural and pericardial effusion as the first manifestations of GCA. The diagnosis was made with a temporal artery biopsy. Such a diagnosis should, therefore, be considered in older patients presenting with pleuropericardial manifestations, even in the absence of typical clinical features.

摘要

巨细胞动脉炎(GCA)是一种病因不明的慢性肉芽肿性血管炎,多见于老年患者,主要累及起源于主动脉弓的动脉的颅部分支。GCA与风湿性多肌痛(PMR)相关。该疾病的临床特征包括头痛、头皮压痛、颌跛行、体格检查时颞动脉异常、视力变化以及与PMR相关的症状。全身表现包括发热、厌食和体重减轻,而较少见的表现与神经系统、呼吸系统、心包和颅外大血管有关。在此,我们报告一例罕见的以同时出现胸腔和心包积液作为GCA首发表现的病例。通过颞动脉活检做出了诊断。因此,对于出现胸膜心包表现的老年患者,即使没有典型的临床特征,也应考虑做出这样的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/03e1/7526968/6362ad09277d/cureus-0012-00000010163-i01.jpg

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