Aortic regurgitation in giant cell arteritis

Klinkhoff, Alice; Reid, Gregory J.; Moscovich, Michael D.

doi:10.1002/art.1780280521

Cited by 16 publications

(4 citation statements)

References 18 publications

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“…Involvement of the thoracic aorta sufficient to result in aortic valve insufficiency, thoracic aortic aneurysms, or dissection of the aorta has been reported previously. Besides the 3 cases in an earlier report (9) which were included here, we identified 44 such cases in 29 reports (11,12,. The majority are in single case reports or small series in which followup was not always a major feature of the paper.…”

Section: Discussionmentioning

confidence: 99%

Thoracic aortic aneurysm and rupture in giant cell arteritis. a descriptive study of 41 cases

Evans

Bowles

Björnsson

et al. 1994

Arthritis & Rheumatism

205

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Objective. To determine the features and outcomes of patients with giant cell arteritis (GCA) who have aneurysms or rupture of the thoracic aorta.Methods. Patients with GCA seen over a 40-year period who had aneurysms and/or rupture of the thoracic aorta were identified by assistance of a computerized indexing system. The presence of thoracic aortic aneurysms (TAA), with or without aortic valve insufficiency (AI), was determined by radiographs, computed tomography scans, and ultrasound studies of the thorax, angiograms of the aorta, and postmortem examination.Results. Ten men and 31 women with GCA were found to have TAA and/or rupture. Three developed TAA before GCA was diagnosed, 5 developed aortic findings near the time of the diagnosis, and 33 after the diagnosis of GCA (median of 7 years after diagnosis). Sixteen patients developed acute aortic dissection, which caused death in 8. Nineteen patients also had A1 due to aortic root dilation, 15 of whom developed congestive heart failure. Eighteen patients underwent 21 surgical procedures for TAA resection and/or aortic valve replacement or repair. Aortitis was documented histologically in 10 cases.Conclusion. Thoracic aortic complications in GCA are associated with serious outcomes that have been underrecognized and may be fatal. Physicians

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Section: Discussionmentioning

confidence: 99%

Thoracic aortic aneurysm and rupture in giant cell arteritis. a descriptive study of 41 cases

Evans

Bowles

Björnsson

et al. 1994

Arthritis & Rheumatism

205

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“…The inflammatory vascular changes produce involvement of the cardiovascular system, lung, kidneys, skin, liver and thyroid [2][3][4][5][6][7][8][9][10][11]. Neuropathy may also accompany GCA.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, other manifestations of the syndrome have been recognised. These findings characteristic of GCA include involvement of the cardiovascular system [2,3], lungs [4][5][6], kidneys [7], skin [8], liver [9], thyroid [10] and nervous system [11]. Neuropathy is an unusual clinical feature of GCA, but has been reported in association with GCA [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Peripheral neuropathy associated with temporal arteritis

et al. 1998

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“…Giant-cell arteritis and rheumatoid arthritis have been associated with aortitis, 22,23 and this patient had aortic regurgitation. Without findings suggestive of giant-cell arteritis or evidence of aortic inflammation, however, I would not pursue these possibilities.…”

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confidence: 83%

Case 19-1998

Shmerling¹,

Caliendo²

1998

N Engl J Med

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A 70-year-old man was admitted to the hospital because of polyarthritis.The patient had been well until 13 days earlier, when he began a 3-day course of treatment with cefixime because of a root-canal operation. Watery diarrhea developed four days later. He took diphenoxylate and then flew to Europe for a one-week vacation. Mild diarrhea continued. Five days before admission, while the patient was still on vacation, his left knee became stiff, painful, and swollen. The next day, these symptoms were worse, and chilliness and night sweats developed. He began a two-day course of treatment with azithromycin. Three days before admission, his right elbow and left thumb became painful and swollen, and he took 2400 mg of ibuprofen in 24 hours, with partial relief of the pain. On the day before admission, he discontinued the ibuprofen. That evening he returned to the United States and found that his temperature was 38.9°C. On the following day, his right knee and left ankle were swollen, and he came to this hospital.The patient was a physician. He had had Reiter's syndrome at the age of 22 years, with monarticular arthritis, urethritis, and conjunctivitis. Physical therapy was administered, and the symptoms subsided within six weeks, without recurrence. He had had mild aortic regurgitation for at least six years. A previous serologic test for syphilis was negative. He took nifedipine and lisinopril for hypertension of 10 years' duration. An operation for prostate cancer had been performed four and a half years before admission, without evidence of recurrence. There was no recent history of nausea, vomiting, abdominal pain or cramps, hematochezia, ocular symptoms, dysuria, rash, ingestion of unusual foods, or exposure to ticks.The temperature was 37.6°C, the pulse was 80, and the respirations were 20. The blood pressure was 130/80 mm Hg.On examination, the patient appeared well. No rash, conjunctival injection, or lymphadenopathy was found. A grade 2 aortic diastolic murmur was heard. The patient could flex his right elbow and extend it over a range of 20 degrees. The left first metacarpophalangeal and interphalangeal joints were swollen, erythematous, and painful. There were effusions in both knees, larger on the left side, with warmth but no erythema; a small effusion was present in the left ankle.The urine was minimally positive for protein. A test for rapid plasma reagin was negative. The prothrombin and partial-thromboplastin times were normal, as were the levels of urea nitrogen, creatinine, glucose, uric acid, calcium, phosphorus, magnesium, electrolytes, and lactate dehydrogenase. The results of other laboratory tests are shown in Tables 1 and 2. A diagnostic procedure was performed.T ABLE 1. H EMATOLOGIC L ABORATORY V ALUES .

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Aortic regurgitation in giant cell arteritis

Cited by 16 publications

References 18 publications

Thoracic aortic aneurysm and rupture in giant cell arteritis. a descriptive study of 41 cases

Thoracic aortic aneurysm and rupture in giant cell arteritis. a descriptive study of 41 cases

Peripheral neuropathy associated with temporal arteritis

Case 19-1998

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