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[双侧亚急性上肢缺血揭示霍顿病,一种罕见的表现形式:病例报告及文献综述]

[Bilateral sub-acute upper limb ischemia revealing Horton's disease, a rare presentation : A case report and literature review].

作者信息

Arbaoui S, Rezziki A, Kejiou H, Serraj K A, Benzirar A, El Mahi O

机构信息

Département de Chirurgie Vasculaire, Université Mohammed Premier, Centre Hospitalier Universitaire Mohammed VI, Oujda, Maroc.

Département de médecine interne, Université Mohammed Premier, Centre Hospitalier Universitaire Mohammed VI, Oujda, Maroc.

出版信息

Ann Cardiol Angeiol (Paris). 2024 Feb;73(1):101677. doi: 10.1016/j.ancard.2023.101677. Epub 2023 Nov 18.

Abstract

STUDY'S GOAL: Our goal is to enrich the medical literature by sharing our experience in managing a case of sub-acute upper limb ischemia that revealed Horton's disease. This is particularly relevant given the current lack of well-established guidelines.

INTRODUCTION

Acute upper limb ischemia is rarely seen in Horton's disease.

CASE REPORT

We present a case of a 63-year-old female patient with sub-acute ischemia in both upper limbs, accompanied by jaw claudication and absence of bilateral temporal pulses. The CT Angiography scan revealed bilateral occlusions and stenosis of the axillary and sub-clavier arteries, as well as involvement of the external carotid arteries and its branches. The Arteriography confirmed abnormalities in the medium-sized arteries of the supra-aortic trunks. The histopathology examination of the temporal artery biopsy was negative. The patient received emergency corticosteroid therapy followed by an immunosuppressant. Due to the improved clinical condition of the upper limbs, surgical intervention was not performed.

摘要

研究目标

我们的目标是通过分享我们在处理一例揭示霍顿病的亚急性上肢缺血病例中的经验,丰富医学文献。鉴于目前缺乏完善的指南,这一点尤为重要。

引言

霍顿病中急性上肢缺血很少见。

病例报告

我们报告一例63岁女性患者,双上肢亚急性缺血,伴有颌部跛行且双侧颞动脉搏动消失。CT血管造影扫描显示双侧腋动脉和锁骨下动脉闭塞及狭窄,以及颈外动脉及其分支受累。动脉造影证实主动脉弓上干的中动脉存在异常。颞动脉活检的组织病理学检查结果为阴性。患者接受了紧急皮质类固醇治疗,随后使用了免疫抑制剂。由于上肢临床状况改善,未进行手术干预。

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