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Giant cell arteritis manifesting as mesenteric ischemia
David Clay Evans1, Michael P Murphy, Jeffrey H Lawson
1Department of Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Journal of Vascular Surgery
|November 9, 2005
Summary
Giant cell arteritis can cause chronic mesenteric ischemia, a rare condition leading to vascular insufficiency. Early diagnosis and glucocorticoid therapy are crucial to prevent severe outcomes, especially before surgical intervention.
Area of Science:
- Vascular Surgery
- Rheumatology
- Internal Medicine
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting medium and large arteries.
- It can manifest with diverse clinical presentations, including abdominal symptoms like chronic mesenteric ischemia.
- Vascular insufficiency due to GCA is often underdiagnosed, potentially leading to adverse outcomes.
Observation:
- An 80-year-old woman presented with chronic mesenteric ischemia.
- Imaging studies revealed stenosis in the superior mesenteric artery and celiac artery.
- Elevated erythrocyte sedimentation rate and a positive temporal artery biopsy confirmed GCA.
Findings:
- Giant cell arteritis was diagnosed as the cause of chronic mesenteric ischemia.
- Glucocorticoid therapy was initiated, indicating a medical management approach.
- The case highlights the importance of considering GCA in patients with unexplained mesenteric vascular disease.
Implications:
- Early recognition of giant cell arteritis is vital to avoid misdiagnosis and inappropriate surgical interventions.
- Prompt glucocorticoid treatment can mitigate the risk of severe vascular complications.
- This case underscores the need for a multidisciplinary approach in managing complex vascular conditions.