Nishino H, DeRemee R A, Rubino F A, Parisi J E
Department of Neurology, Mayo Clinic Jacksonville, Florida.
Mayo Clin Proc. 1993 Feb;68(2):115-21. doi: 10.1016/s0025-6196(12)60157-8.
Between January 1973 and October 1991 at the Mayo Clinic, 5 of 345 patients with Wegener's granulomatosis initially had features suggestive of giant cell arteritis and subsequently were found to have biopsy-proven vasculitis of the temporal artery. All five patients were older than 60 years of age and had jaw claudication, sudden loss of vision, severe headache with or without diplopia, or polymyalgia rheumatica at the time of initial examination. The erythrocyte sedimentation rate was high at the time of onset of symptoms in four patients (and unavailable in one patient). A temporal artery biopsy specimen revealed giant cell arteritis in one patient and non-giant cell arteritis in four patients. All five patients subsequently had pulmonary and renal lesions characteristic of Wegener's granulomatosis, with typical histopathologic features on biopsy or positive cytoplasmic staining antineutrophil cytoplasmic antibodies. Thus, overlapping features of giant cell arteritis and Wegener's granulomatosis do occur in some patients.
1973年1月至1991年10月期间，在梅奥诊所，345例韦格纳肉芽肿患者中有5例最初具有提示巨细胞动脉炎的特征，随后经活检证实患有颞动脉血管炎。所有5例患者年龄均超过60岁，初诊时均有颌部跛行、突然失明、伴有或不伴有复视的严重头痛或风湿性多肌痛。4例患者在症状发作时红细胞沉降率升高（1例患者数据未提供）。颞动脉活检标本显示，1例患者为巨细胞动脉炎，4例患者为非巨细胞动脉炎。所有5例患者随后均出现韦格纳肉芽肿特有的肺部和肾脏病变，活检具有典型的组织病理学特征或抗中性粒细胞胞浆抗体胞浆染色阳性。因此，巨细胞动脉炎和韦格纳肉芽肿的重叠特征确实在一些患者中出现。
