Lambert M, Weber A, Boland B, De Plaen J F, Donckier J
Division of General Internal Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Clin Rheumatol. 1996 Mar;15(2):174-80. doi: 10.1007/BF02230336.
Diffuse arterial involvement in giant cell arteritis (GCA) is well recognized. By contrast, GCA clinically isolated to large vessels without cephalic, rheumatologic or systemic symptoms represents a much rarer manifestation of the disease. We report the cases of 4 elderly women presenting with a diffuse and symptomatic occlusive disease without the typical signs of temporal arteritis, in whom biological, angiographic or pathological findings were suggestive of GCA. Medium to high dose oral corticosteroids were given to the 4 patients, in combination with various revascularization procedures, allowing a fair clinical response. Large vessel arteritis should be considered in elderly women with diffuse non-atherosclerotic occlusive disease and elevated erythrocyte sedimentation rate, even if typical features of GCA are lacking. In those cases, a long-term treatment with corticosteroids is mandatory, but surgical or angioplastic revascularization is often required.
巨细胞动脉炎（GCA）中动脉弥漫性受累已得到充分认识。相比之下，临床上仅累及大血管而无头部、风湿或全身症状的GCA是该疾病一种罕见得多的表现形式。我们报告了4例老年女性病例，她们表现为弥漫性且有症状的闭塞性疾病，无颞动脉炎的典型体征，其生物学、血管造影或病理学检查结果提示为GCA。对这4例患者给予了中高剂量口服糖皮质激素，并结合各种血管重建手术，取得了较好的临床反应。对于患有弥漫性非动脉粥样硬化性闭塞性疾病且红细胞沉降率升高的老年女性，即使缺乏GCA的典型特征，也应考虑大血管动脉炎。在这些病例中，必须进行长期糖皮质激素治疗，但通常还需要手术或血管成形术进行血管重建。
