Hernández Michel, Rodríguez Laura C, Bastidas Nicolás, Rincón Oscar
Hospital Universitario de la Samaritana, Bogota, Colombia.
Universidad de la Sabana, Chia, Colombia.
Radiol Case Rep. 2022 Jun 28;17(9):3191-3195. doi: 10.1016/j.radcr.2022.06.015. eCollection 2022 Sep.
Giant cell arteritis is an autoimmune disease that affects medium and large caliber vessels, creating deposits of inflammatory clusters on the arterial wall. It is the most common form of large vessel vasculitis, but given the variability of biopsy efficiency and of other diagnostic strategies employed, the diagnosis of this disease is challenging. We report the case of a 69-year-old female patient who presented with neurological deficit and increased bilateral sensation in the temporal region associated with excruciating headache. Workup revealed calcification of the superficial temporal, vertebral and ophthalmic arteries, as well as suggestive findings on Doppler ultrasound such as the halo sign, pointing to superficial temporal arteritis though not excluding the possibility of those calcifications being consistent with atherosclerosis in a patient with advanced chronic renal disease, which has been reported as giving rise to false-positive results. Knowledge of the main differences between the 2 diagnoses is important, given the wide range of diagnostic imaging possibilities which can avoid the need for biopsy.
巨细胞动脉炎是一种自身免疫性疾病，会影响中、大动脉，在动脉壁上形成炎症性簇状沉积物。它是大血管血管炎最常见的形式，但鉴于活检效率及所采用的其他诊断策略的可变性，这种疾病的诊断具有挑战性。我们报告了一例69岁女性患者的病例，该患者出现神经功能缺损，颞部双侧感觉增强并伴有剧痛性头痛。检查发现颞浅动脉、椎动脉和眼动脉钙化，以及多普勒超声检查的提示性结果，如晕征，提示颞浅动脉炎，但不排除这些钙化与晚期慢性肾病患者的动脉粥样硬化相符的可能性，已有报道称这会导致假阳性结果。鉴于广泛的诊断成像可能性可避免活检的需要，了解这两种诊断之间的主要差异很重要。
