Document Detail


Temporal arteritis: diagnostic and therapeutic considerations.
MedLine Citation:
PMID:  8651526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Background: Giant cell arteritis of surgical significance includes two clinical entities, temporal arteritis and Takayasu's arteritis, and they are pathologically indistinguishable from one another. This study summarizes our experience in 21 cases of temporal arteritis during a recent 5-year period. Patient Population and Results: This study includes patients who were discharged with a clinical diagnosis of temporal arteritis. There were 12 women and 9 men, with a mean age of 69 years. Six patients were admitted with an initial diagnosis of polymyalgia rheumatica, nine with severe headache and/or nonspecific symptoms, three with ischemic symptoms of the limbs, one with a cerebrovascular accident, one with syncope, and one with osteomyelitis of the limb. The sedimentation rate ranged from 26 to 110, with a mean of 41. Eight patients had a preoperative duplex ultrasound of their temporal arteries; six of these had a peak systolic velocity of 2 > or = 200 cm/s, and five had a positive temporal artery biopsy. Nineteen patients had temporal artery biopsies, 15 were positive for giant cell arteritis, and the diagnosis was not conclusive in 4. All patients were treated with prednisone with a satisfactory outcome, except for two who had ischemic symptoms of the upper extremity requiring a carotid-axillary artery bypass in one and a carotid-brachial artery bypass in the other. Both patients had satisfactory outcomes after surgery. Conclusions: The primary treatment of temporal arteritis is medical, and surgery should be reserved for severe specific disabling symptoms that have failed medical therapy. Duplex ultrasound might be helpful in predicting the side and location for temporal artery biopsy.
Authors:
A F AbuRrahma; L Thaxton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American surgeon     Volume:  62     ISSN:  0003-1348     ISO Abbreviation:  Am Surg     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1996-07-25     Completed Date:  1996-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370522     Medline TA:  Am Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  449-51     Citation Subset:  IM    
Affiliation:
Robert C. Byrd Health Sciences Center of West Virginia University, Charleston, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Axillary Artery / surgery
Biopsy
Blood Flow Velocity
Blood Sedimentation
Brachial Artery / surgery
Carotid Arteries / surgery
Cerebrovascular Disorders / diagnosis
Extremities / blood supply
Female
Giant Cell Arteritis / diagnosis*,  drug therapy*,  surgery,  ultrasonography
Headache / diagnosis
Humans
Ischemia / diagnosis
Male
Osteomyelitis / diagnosis
Prednisone / therapeutic use
Syncope / diagnosis
Takayasu Arteritis / diagnosis
Temporal Arteries / ultrasonography
Treatment Outcome
Ultrasonography, Doppler, Duplex
Chemical
Reg. No./Substance:
53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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