Healey L A, Wilske K R
Arthritis Rheum. 1980 Jun;23(6):641-3. doi: 10.1002/art.1780230605.
Temporal headache, blindness, and polymyalgia rheumatica are well-recognized manifestions of giant cell arteritis. However, the disease may present in less evident fashion as shown by 30 of 74 patients with biopsy-proven giant cell arteritis whose predominant complaint was not one ot these cardinal symptoms. For this group of 30, the main problem was fever in 12 patients, anorexia, weight loss, and elevated serum alkaline phosphatase level suggesting an occult malignancy in 7, and unexplained anemia in 3. Four patients had a neurologic syndrome; 2 had diplopia and 2 acute weakness of one arm. Claudication was the chief complaint of 4 patients, involving the leg in 1, the arm in 1, and the jaw in 2. All patients responded well to steroid therapy.
颞部头痛、失明和风湿性多肌痛是巨细胞动脉炎公认的表现。然而，该疾病可能以不太明显的方式呈现，74例经活检证实为巨细胞动脉炎的患者中有30例就是如此，他们的主要症状并非这些典型症状之一。对于这30例患者，主要问题是12例患者发热，7例患者出现厌食、体重减轻和血清碱性磷酸酶水平升高提示隐匿性恶性肿瘤，3例患者出现不明原因贫血。4例患者有神经综合征；2例患者有复视，2例患者有一侧手臂急性无力。跛行是4例患者的主要症状，其中1例累及腿部，1例累及手臂，2例累及下颌。所有患者对类固醇治疗反应良好。
