Rivers S P, Baur G M, Inahara T, Porter J M
Am J Surg. 1982 May;143(5):554-8. doi: 10.1016/0002-9610(82)90160-x.
Six cases of arterial insufficiency of the arm secondary to giant cell arteritis are described, all in elderly white women. The clinical presentation of the occlusive disease ranged from an asymptomatic incidental physical finding to an alarming picture of severe ischemia. All patients were treated with steroids and had subsequent stabilization or improvement of extremity symptoms. Vascular reconstruction was also performed in two patients, one of whom developed rest pain after graft occlusion. Another patient had a cerebral infarction while taking prednisone, despite control of large vessel vasculitis. This study indicates that giant cell arteritis should be considered in cases of occlusive disease of the arms, especially in elderly women. Giant cell arteritis is a seriously morbid and potentially fatal disease which justifies a thorough evaluation when sufficient evidence is present to suggest the diagnosis. The response to steroids is usually adequate to eliminate the need for early surgical intervention.
本文描述了6例继发于巨细胞动脉炎的手臂动脉供血不足病例，所有患者均为老年白人女性。闭塞性疾病的临床表现从无症状的偶然体格检查发现到严重缺血的警示性表现不等。所有患者均接受了类固醇治疗，随后肢体症状稳定或改善。两名患者还接受了血管重建手术，其中一名患者在移植物闭塞后出现静息痛。另一名患者在服用泼尼松期间发生了脑梗死，尽管大血管血管炎得到了控制。本研究表明，对于手臂闭塞性疾病患者，尤其是老年女性，应考虑巨细胞动脉炎。巨细胞动脉炎是一种严重的疾病，有潜在致命风险，当有足够证据提示诊断时，有必要进行全面评估。对类固醇的反应通常足以避免早期手术干预的需要。
