Ultragarsinio tyrimo reikšmė sergant temporaliniu arteritu

Introduction. Temporal arteritis (TA) is usually diagnosed according to clinical criteria, and temporal artery biopsy is considered as a golden standard for the diagnosis. Temporal artery biopsy is a surgical intervention on a head site and is not well-tolerated by the patients. As an alternative for temporal artery investigation, ultrasound examination may be used. The aim of this pilot study was to evaluate the performance of ultrasound examination of a temporal artery of patients with and without TA, but with similar clinical findings. Materials and results. Thirteen patients seen at Vilnius University Hospital Santariškių Klinikos during 2006–2009 with suspicion of TA were included into this study, and ultrasound examination of their both right and left superficial temporal arteries was performed. Eight patients were diagnosed with TA according to clinical criteria, and 5 patients had headaches of another origin. Two patients had a biopsy-proven diagnosis. The thickened wall (“halo” sign) and / or stenosis / occlusion were found on ultrasound examination in three patients. The presence of abnormality was found in five patients from the setting of TA patients, and no abnormalities were detected in the control group. Although the groups were very small and the data scanty, we consider the sensitivity of the abnormalities detected by ultrasound to be 62.5%, and the specifi city was close to 100% in this pilot study. Conclusions. Authors recommend bilateral ultrasound examination of temporal arteries for patients with suspicion of giant cell arteritis (temporal arteritis). Our pilot study showed a suffi cient sensitivity of this diagnostic test, although it greatly depends on the experience and skills of the performer

Temporal Arteritis Presenting with Gastrointestinal Symptoms in a Middle Aged Man

Giant cell arteritis, also known as temporal arteritis, is a vasculitis of unknown etiology that classically involves the wall of the large to medium size. We are reporting a case of a young onset temporal arteritis presenting with gastrointestinal symptoms. The patient was a 48-year-old male who presented with a 2-week history of fever, diffuse abdominal pain, and malaise. He underwent a laparoscopic cholecystectomy after findings of elevated bilirubin and alkaline phosphatase as well as suspicion of porcelain gallbladder on ultrasound (or computed tomography scan). The patient subsequently developed painless, intermittent vision loss and unilateral headaches. A work-up included temporal artery biopsy, which showed marked lymphocytic infiltrate in the arterial wall consistent with temporal arteritis. The presentation of temporal arteritis may be atypical. We are reporting a case of temporal arteritis at a young age presenting mainly with gastrointestinal symptoms

Vasculites dos médios e grandes vasos Medium and large vessel vasculitis

As vasculites são constituídas por um grande grupo de síndromes caracterizadas por inflamação e necrose da parede dos vasos sangüíneos, resultando em estreitamento ou oclusão do lúmen. A distribuição dos vasos envolvidos varia consideravelmente e serve de base para a classificação das síndromes vasculíticas: grandes vasos (arterite de Takayasu, arterite temporal); pequenos e médios vasos (poliarterite nodosa, síndrome de Churg-Strauss, granulomatose de Wegener, vasculites nas doenças reumáticas); e pequenos vasos (vasculite de hipersensibilidade, púrpura de Henoch-Schonlein, poliangeíte microscópica, crioglobulinemia). Este artigo revisa as vasculites dos médios e grandes vasos e opções terapêuticas atuais; além de oferecer orientação sobre abordagem diagnóstica e tratamento dos pacientes com suspeita de vasculite cutânea.<br>Vasculitis comprises a broad group of syndromes characterized by inflammation and necrosis on the walls of blood vessels, resulting in narrowing or occlusion of the lumen. The distribution of involved blood vessel varies considerably and serves as the basis for one classification of vasculitic syndromes: large vessels (Takayasu arteritis, giant cell arteritis); medium and small muscular arteries (polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, vasculitis in rheumatic diseases); and small vessels ("hypersensitivity" vasculitis, Henoch-Schonlein purpura, microscopic polyangiitis, cryoglobulinemia). This article reviews medium and large vessel vasculitis and current treatment options; it also presents a comprehensive approach to diagnosing and treating patients with suspected cutaneous vasculitis