Ohta Ryuichi, Nishikura Nozomi, Ikeda Hirotaka, Sano Chiaki
Community Care, Unnan City Hospital, Unnan, JPN.
Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus. 2023 Jun 8;15(6):e40146. doi: 10.7759/cureus.40146. eCollection 2023 Jun.
Giant cell arteritis (GCA) causes systemic symptoms; however, involvement of the lungs is relatively rare compared to other rheumatic diseases such as rheumatoid arthritis and systemic sclerosis. Diagnosis and treatment of GCA complicated by chronic lung diseases can be challenging. In this case, an 87-year-old male presented with the chief complaints of systemic muscular pain and cough. The patient was eventually diagnosed with GCA complicated by chronic bronchitis. Although GCA treatment with chronic bronchitis is uncertain, we treated the patient with tapering doses of prednisolone and tocilizumab, which were effective. In older patients with systemic muscular pain and cough, GCA can be considered a differential diagnosis, and tocilizumab can be a reliable treatment in cases complicated by lung diseases, similar to other rheumatic diseases.
巨细胞动脉炎(GCA)可引起全身症状;然而,与类风湿关节炎和系统性硬化症等其他风湿性疾病相比,肺部受累相对少见。GCA合并慢性肺部疾病的诊断和治疗可能具有挑战性。在本病例中,一名87岁男性以全身肌肉疼痛和咳嗽为主诉就诊。该患者最终被诊断为GCA合并慢性支气管炎。虽然GCA合并慢性支气管炎的治疗方法尚不明确,但我们给予患者逐渐减量的泼尼松龙和托珠单抗治疗,效果良好。对于有全身肌肉疼痛和咳嗽的老年患者,GCA可作为鉴别诊断考虑,并且与其他风湿性疾病类似,托珠单抗在合并肺部疾病的病例中可能是一种可靠的治疗方法。