Vijayaraghavan Nimal, Martin Jaye, Jayawickrama Waranga, Otome Ohide
Department of General Medicine, Rockingham General Hospital, Cooloongup, Western Australia, Australia
Department of General Medicine, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
BMJ Case Rep. 2023 Jan 11;16(1):e251406. doi: 10.1136/bcr-2022-251406.
Two male patients aged above 70 years were investigated for chronic non-specific symptoms and evidence of significant systemic inflammation, but without classic 'cranial symptoms' of giant cell arteritis (GCA). Each patient had multiple non-diagnostic investigations, but finally extensive large-vessel vasculitis was revealed by whole body positron emission tomography/CT imaging. Both cases were confirmed to have GCA on temporal artery biopsy and responded well to initial high-dose prednisolone therapy. The patients successfully completed 12 months of steroid-sparing therapy with tocilizumab and achieved remission of their condition.
两名70岁以上男性患者因慢性非特异性症状和明显全身炎症证据接受调查，但无巨细胞动脉炎（GCA）的典型“颅脑症状”。每位患者都进行了多次非诊断性检查，但最终全身正电子发射断层扫描/CT成像显示为广泛性大血管血管炎。颞动脉活检证实两例均为GCA，且对初始高剂量泼尼松龙治疗反应良好。患者成功完成了为期12个月的托珠单抗激素节省治疗，并实现了病情缓解。
