Document Detail


Two cases of recurrent stroke in treated giant cell arteritis: diagnostic and therapeutic dilemmas.
MedLine Citation:
PMID:  20661069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is not established whether the increased risk of stroke in patients with giant cell arteritis (GCA) is because of atherosclerosis, persistent arterial inflammation, or an iatrogenic effect of corticosteroids. This creates difficulties in choosing the most appropriate treatment. We report 2 patients with GCA who developed repeated strokes involving different arterial territories following initiation of corticosteroid therapy, despite resolution of cranial symptoms and normalization of inflammatory markers. Subsequent investigation suggested persisting arteritis as the cause of these strokes. The cases revealed the limitations of laboratory tests or imaging techniques in determining the cause of stroke in recently diagnosed GCA. There is a need to develop effective means of monitoring GCA activity and to determine the most effective treatment approach in this circumstance.
Authors:
Alasdair J Fitzgerald; James W Ironside; David M Summers; Martin S Dennis; Euan R McRorie
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases     Volume:  16     ISSN:  1536-7355     ISO Abbreviation:  J Clin Rheumatol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-12-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9518034     Medline TA:  J Clin Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  225-8     Citation Subset:  IM    
Affiliation:
Department of Rehabilitation Medicine, Astley Ainslie Hospital, Edinburgh, Scotland. alasdair.fitzgerald@nhs.net
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects,  therapeutic use
Aged, 80 and over
Biopsy
Female
Giant Cell Arteritis / complications*,  drug therapy*,  pathology
Humans
Male
Middle Aged
Prednisolone / adverse effects,  therapeutic use
Recurrence
Risk Factors
Stroke / diagnosis*,  epidemiology*
Temporal Arteries / pathology
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 50-24-8/Prednisolone

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


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