McLean R M, Greco T P
Clin Rheumatol. 1995 Mar;14(2):191-6. doi: 10.1007/BF02214942.
A series of seven patients with the polymyalgia rheumatica-temporal arteritis (PMR-TA) complex is presented, each of whom during the clinical course demonstrated the presence of anticardiolipin antibodies (ACLs). Presenting symptoms consisted of proximal myalgias and stiffness characteristic of PMR in five patients and of visual symptoms and headache suspicious for TA in two patients. Two of the five PMR patients later developed jaw claudication characteristic of TA. Six of the seven cases demonstrated clinical evidence of a vasculopathic process such as a cerebrovascular infarct or a vasculitic syndrome. Previous studies have suggested an association between ACLs and PMR-TA, and this series of patients appears to provide more supporting evidence. Even patients who only manifested PMR symptoms without suggestion of accompanying TA developed vascular complications. An increasing range of symptoms have been recognized in association with ACLs, and the vasculitic syndromes of PMR-TA should be included as a possible association. While this series together with previous studies may suggest that the presence of ACLs in patients with PMR-TA symptoms may serve as a marker for the development of vascular complications, larger longitudinal studies will be necessary in the future.
本文报告了7例风湿性多肌痛-颞动脉炎（PMR-TA）综合征患者，每位患者在临床病程中均显示存在抗心磷脂抗体（ACL）。5例患者的首发症状为PMR典型的近端肌痛和僵硬，2例患者的首发症状为疑似TA的视觉症状和头痛。5例PMR患者中有2例后来出现了TA典型的颌部跛行。7例患者中有6例有血管病变过程的临床证据，如脑血管梗死或血管炎综合征。先前的研究表明ACL与PMR-TA之间存在关联，本系列患者似乎提供了更多支持证据。即使是仅表现出PMR症状而无伴随TA迹象的患者也出现了血管并发症。与ACL相关的症状范围越来越广，PMR-TA的血管炎综合征应被视为一种可能的关联。虽然本系列研究以及先前的研究可能表明，有PMR-TA症状的患者中ACL的存在可能是血管并发症发生的一个标志物，但未来还需要进行更大规模的纵向研究。
