Wenger M, Schneider J
Institut für klinische Pathologie, Universität Zürich.
Vasa. 1996;25(4):373-7.
The autopsy findings of a 74-year-old women who unexpectedly died are presented. She had suffered from polymyalgia but typical symptoms of temporal arteritis had been absent and tentative treatment with prednisone had not improved the polymyalgic pain. The autopsy revealed a generalized giant cell arteritis involving the left temporal artery, the left common carotid artery, the ascending aorta, a submucosal artery of the ileum and the left anterior descending branch of the coronary arteries. Histology showed typical granulomatous infiltrates including giant cells, followed by thrombotical occlusion of the coronary artery branch and subsequent myocardial infarction. Giant cell arteritis is a systemic vasculitis of aged subjects with predominant localisation in the cranial arteries, but occasional involvement of any type of visceral and peripheral arteries. Coronary involvement with sudden cardiac death is not a commen complication of giant cell arteritis but has occasionally been described in the literature.
本文报告了一名74岁意外死亡女性的尸检结果。她患有多肌痛,但无颞动脉炎的典型症状,泼尼松试验性治疗未能改善多肌痛性疼痛。尸检显示广泛性巨细胞动脉炎,累及左颞动脉、左颈总动脉、升主动脉、回肠黏膜下动脉和冠状动脉左前降支。组织学检查显示典型的肉芽肿性浸润,包括巨细胞,随后冠状动脉分支血栓形成闭塞,继而发生心肌梗死。巨细胞动脉炎是一种老年系统性血管炎,主要累及颅动脉,但偶尔也会累及任何类型的内脏和外周动脉。冠状动脉受累导致心源性猝死并非巨细胞动脉炎的常见并发症,但文献中偶尔有相关描述。