scholarly journals Hepatic Giant Cell Arteritis and Polymyalgia Rheumatica

1994 ◽  
Vol 8 (1) ◽  
pp. 36-38 ◽  
Author(s):  
Donald R Duerksen ◽  
Laurence D Jewell ◽  
Vincent G Bain
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
The Elderly ◽  
Good Prognosis ◽  
Clinical Syndrome ◽  
Low Grade ◽  
Erythrocyte Sedimentation ◽  
Systemic Corticosteroids ◽  
Wedge Biopsy

Polymyalgia rheumatica (PMR) is a clinical syndrome of the elderly characterized by malaise, proximal muscle aching and stiffness, low grade fever, elevated erythrocyte sedimentation rare and the frequent association with temporal giant cell arteritis. The authors describe a case of PMR associated with hepatic giant cell arteritis. This lesion has been described in two other clinical reports. The distribution of the arteritis may be patchy; in this report, diagnosis was made with a wedge biopsy performed after an initial nonspecific percutaneous liver biopsy. The authors review the spectrum of liver involvement in PMR and giant cell arteritis. Hepatic abnormalities respond to systemic corticosteroids, and patients with hepatic arteritis have a good prognosis.

Polymyalgia Rheumatica - a Disease of the Elderly

2018 ◽  
Vol 69 (1) ◽  
pp. 152-154
Author(s):  
Vasilica Cristescu ◽  
Aurelia Romila ◽  
Luana Andreea Macovei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Clinical Aspects ◽  
Immune Disorder ◽  
Markers Of Inflammation

Polymyalgia rheumatica is a disease that occurs mostly in the elderly and is rarely seen in patients less than 50 years of age. Polymyalgia rheumatica is a vasculitis, which manifests itself as an inflammatory disease of the vascular wall that can affect any type of blood vessel, regardless of its size. It has been considered a form of giant cell arteritis, involving primarily large and medium arteries and to a lesser extent the arterioles. Clinical manifestations are caused by the generic pathogenic process and depend on the characteristics of the damaged organ. PMR is a senescence-related immune disorder. It has been defined as a stand-alone condition and a syndrome referred to as rheumatic polyarteritis with manifestations of giant cell arteritis (especially in cases of Horton�s disease and temporal arteritis) which are commonly associated with polymyalgia. The clinical presentation is clearly dominated by the painful girdle syndrome, with a feeling of general discomfort. Polymyalgia and temporal arteritis may coexist or be consecutive to each other in the same patient, as in most of our patients. The present study describes 3 cases of polymyalgia rheumatica, admitted to the Clinic of Rheumatology of Sf. Apostol Andrei Hospital, Galati. The cases were compared with the literature. Two clinical aspects (polymyalgia rheumatica and/or Horton�s disease) and the relationship between them were also considered. Polymyalgia rheumatica is currently thought to have a multifactorial etiology, in which the following factors play a role: genetic factors or hereditary predisposition (some individuals are more prone to this disease), immune factors and viral infections (triggers of the disease). Other risk factors of polymyalgia rheumatica include age over 50 years and the association with giant cell arteritis. The characteristic feature of the disease is girdle pain, with intense stiffness of at least one hour�s duration. Markers of inflammation, erythrocyte sedimentation rate and C-reactive protein are almost always increased at the onset of the disease. Diseases that can mimic the clinical picture of polymyalgia rheumatica are neoplasia, infections, metabolic disorders of the bone and endocrine diseases.

scholarly journals Should Ultrasonographic Giant-Cell Arteritis Signs be Detected in Patients with Polymyalgia Rheumatica?

2021 ◽  
Author(s):  
Fazıl Kulaklı ◽  
İlker Fatih Sari ◽  
Erdem Çaylı ◽  
Nurçe Çilesizoğlu Yavuz
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Polymyalgia Rheumatica ◽  
Control Group ◽  
Newly Diagnosed ◽  
Erythrocyte Sedimentation ◽  
Experienced Radiologist ◽  
Significant Difference

Assessing the presence of ultrasonographic findings of Giant-Cell Arteritis in Polymyalgia Rheumatica patients using Ultrasonography on the temporal artery. The study contributes to the literature evaluating the unclear relationship between Polymyalgia Rheumatica and Giant-Cell Arteritis. It raises awareness that Ultrasonography can be used instead of biopsy in patients with suspected Giant-Cell Arteritis. Twenty patients were newly diagnosed with Polymyalgia Rheumatica, and 20 participants as a control group were included in the study. While the Polymyalgia Rheumatica group was evaluated at baseline and sixth month, the control group was evaluated only at baseline. Laboratory, clinical and ultrasonographic findings of all participants were assessed. Gray-scale Ultrasonography and colored Doppler Ultrasonography were used to present halo and compression, occlusion, and stenosis in addition to intima-media complex thickness in bilateral temporal arteries and frontal-parietal branches by an experienced radiologist blinded to the subject. No significant difference was found between Polymyalgia Rheumatica and control groups based on demographic features, clinical and ultrasonographic results at baseline and sixth month. Erythrocyte sedimentation rate of Polymyalgia Rheumatica at baseline was statistically higher than the control group. Erythrocyte sedimentation rate values have declined significantly in Polymyalgia Rheumatica patients, but no significant changes were found for clinical or ultrasonographic features during the sixth month. Ultrasonographic findings of Giant-Cell Arteritis are not present in newly diagnosed and six months followed up Polymyalgia Rheumatica patients. Further studies are needed.

scholarly journals Clinical implication of FDG-PET/CT in monitoring disease activity in large-vessel giant cell arteritis linked with secondary polymyalgia rheumatica

2014 ◽  
Vol 1 (1) ◽  
pp. 6 ◽  
Author(s):  
Yoshinori Taniguchi ◽  
Shuichi Nakayama ◽  
Yoshio Terada
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Fdg Pet ◽  
Pelvic Girdle ◽  
Large Vessel ◽  
Pelvic Girdle Pain ◽  
Low Grade ◽  
Pet Ct ◽  
Fdg Pet Ct

Seventy year-old female presented low-grade fever, neck and pelvic girdle pain, jaw claudication and pulseless without visual disturbance. Laboratory examinations showed that C-reactive protein and erythrocyte sedimentation rate (ESR) were 11 mg/dl and 123 mm/1hr, respectively. FDG-PET/CT findings demonstrated bilateral subclavian, carotid and femoral arteritis and aortitis in addition to bursitis and enthesitis of spinous process and pelvic girdle. We diagnosed as large-vessel giant cell arteritis (GCA) linked with secondary polymyalgia rheumatica (PMR). Glucocorticoid therapy was started, and not only these symptoms and but also abnormal findings of FDG-PET/CT were improved.

Polymyalgia rheumatica and giant cell arteritis: management of two diseases of the elderly

Aging Health ◽  
2011 ◽  
Vol 7 (4) ◽  
pp. 633-645 ◽  
Author(s):  
Christian Dejaco ◽  
Christina Duftner ◽  
Bhaskar Dasgupta ◽  
Eric L Matteson ◽  
Michael Schirmer
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
The Elderly

scholarly journals Tongue Necrosis as an Initial Manifestation of Giant Cell Arteritis: Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Jose R. Zaragoza ◽  
Natalia Vernon ◽  
Gisoo Ghaffari
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Vision Loss ◽  
Systemic Vasculitis ◽  
The Elderly ◽  
External Carotid Artery ◽  
External Carotid ◽  
Low Grade ◽  
Initial Manifestation ◽  
Atypical Manifestations

Giant cell arteritis (GCA) is a systemic vasculitis of medium and large arteries that mainly affects the external carotid artery. It is a diagnosis of the elderly that typically presents as low-grade fever, temporal tenderness, claudication of the jaw, and in some patients vision loss. In cases where GCA presents with atypical manifestations, the diagnosis may be more difficult, causing a delay in both diagnosis and treatment and ultimately leading to irreversible complications. In this paper, we present an atypical presentation of GCA with symptoms of neck swelling and lingual pain in an elderly female. These symptoms progressed to bilateral necrosis and eventual dislodgement of the tongue. Lingual necrosis is a severe potential complication in GCA. In patients presenting with lingual swelling, pain, and discoloration, GCA should be suspected and prompt therapy should be initiated to avoid irreversible complications.

scholarly journals Should Ultrasonographic Giant-Cell Arteritis Signs be Detected in Patients with Polymyalgia Rheumatica?

2021 ◽  
Vol 7 (1) ◽  
pp. 10
Author(s):  
Fazıl Kulaklı ◽  
İlker Fatih Sari ◽  
Erdem Çaylı ◽  
Nurçe Çilesizoğlu Yavuz
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Polymyalgia Rheumatica ◽  
Control Group ◽  
Newly Diagnosed ◽  
Erythrocyte Sedimentation ◽  
Experienced Radiologist ◽  
Significant Difference

Assessing the presence of ultrasonographic findings of Giant-Cell Arteritis in Polymyalgia Rheumatica patients using Ultrasonography on the temporal artery. The study contributes to the literature evaluating the unclear relationship between Polymyalgia Rheumatica and Giant-Cell Arteritis. It raises awareness that Ultrasonography can be used instead of biopsy in patients with suspected Giant-Cell Arteritis. Twenty patients were newly diagnosed with Polymyalgia Rheumatica, and 20 participants as a control group were included in the study. While the Polymyalgia Rheumatica group was evaluated at baseline and sixth month, the control group was evaluated only at baseline. Laboratory, clinical and ultrasonographic findings of all participants were assessed. Gray-scale Ultrasonography and colored Doppler Ultrasonography were used to present halo and compression, occlusion, and stenosis in addition to intima-media complex thickness in bilateral temporal arteries and frontal-parietal branches by an experienced radiologist blinded to the subject. No significant difference was found between Polymyalgia Rheumatica and control groups based on demographic features, clinical and ultrasonographic results at baseline and sixth month. Erythrocyte sedimentation rate of Polymyalgia Rheumatica at baseline was statistically higher than the control group. Erythrocyte sedimentation rate values have declined significantly in Polymyalgia Rheumatica patients, but no significant changes were found for clinical or ultrasonographic features during the sixth month. Ultrasonographic findings of Giant-Cell Arteritis are not present in newly diagnosed and six months followed up Polymyalgia Rheumatica patients. Further studies are needed.

Microheterogeneity of α1-antichymotrypsin in the management of giant-cell arteritis and polymyalgia rheumatica

1990 ◽  
Vol 78 (6) ◽  
pp. 557-564 ◽  
Author(s):  
Eric Hachulla ◽  
Anne Laine ◽  
Annette Hayem
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Erythrocyte Sedimentation Rate ◽  
Concanavalin A ◽  
Sedimentation Rate ◽  
Polymyalgia Rheumatica ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Active Disease

1. Using crossed immunoaffinity electrophoresis with free concanavalin A in the first dimension, we studied the glycan microheterogeneity of α1-antichymotrypsin in sera from patients with giant-cell arteritis and/or polymyalgia rheumatica, and its variation in the serum of several of these patients during induction of disease remission by prednisone therapy and possible further recurrence of giant-cell arteritis and/or polymyalgia rheumatica. 2. In the serum of patients with active disease we observed increased proportions of concanavalin A non-reactive and concanavalin A weakly reactive fractions. The results were expressed as the ratio of concanavalin A non-reactive fraction plus concanavalin A weakly reactive fraction to concanavalin A reactive fraction, called Rα1-ACT. An Rα1-ACT higher than 1.8 (upper normal value) was found in 30/31 sera from patients with active disease (sensitivity 97%) and in 2/22 sera from patients with inactive disease (specificity 91%). 3. The erythrocyte sedimentation rate and the serum C-reactive protein level, common markers of biological inflammation, are usually elevated in active giant-cell arteritis and/or polymyalgia rheumatica. The two parameters are commonly used to guide the therapy during the course of the disease, but they have no specificity. An erythrocyte sedimentation rate of greater than 30 mm/h was found in 30/31 sera from patients with active disease (sensitivity 97%) and in 5/22 sera from patients with inactive disease (specificity 77%). Our results show that α1-antichymotrypsin microheterogeneity provides a precise marker of giant-cell arteritis and/or polymyalgia rheumatica activity, particularly when the serum C-reactive protein level is normal or when the erythrocyte sedimentation rate is still high in treated patients. We found a better positive prediction value for Rα1-ACT than for erythrocyte sedimentation rate (94% and 86%, respectively). By determining the Rα1-ACT it is thus possible to follow the exacerbation of the disease when the dose of prednisone is tapered. 4. The correlation coefficients between clinical symptoms, erythrocyte sedimentation rate, levels of C-reactive protein or α1-antichymotrypsin, and Rα1-ACT values were determined. The highest correlation occurred between Rα1-ACT and erythrocyte sedimentation rate (r = 0.57, P <0.0001). 5. Three case reports illustrated the value of determining Rα1-ACT as a useful adjunct test for the diagnosis of giant-cell arteritis and/or polymyalgia rheumatica.

Musculoskeletal system

2018 ◽  
Author(s):  
Lesley K. Bowker ◽  
James D. Price ◽  
Ku Shah ◽  
Sarah C. Smith
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Musculoskeletal System ◽  
Polymyalgia Rheumatica ◽  
Cervical Spondylosis ◽  
The Elderly ◽  
Painful Shoulder ◽  
Osteoporosis Management ◽  
System P ◽  
Painful Hip

This chapter provides information on osteoarthritis, management of osteoarthritis, osteoporosis, management of osteoporosis, polymyalgia rheumatica, giant cell arteritis, muscle symptoms, Paget’s disease, gout, pseudogout, contractures, cervical spondylosis and myelopathy, osteomyelitis, the elderly foot, the elderly hand, the painful hip, the painful back, and the painful shoulder.

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