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Related Experiment Videos

Temporal arteritis revealed by upper limb gangrene.

C de Gennes1, D Le Thi Huong, B Wechsler

  • 1Service de Médecine Interne, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.

The Journal of Rheumatology
|January 1, 1989
PubMed
Summary

Digital gangrene in an elderly man, coupled with an elevated erythrocyte sedimentation rate (ESR), may indicate temporal arteritis. Prompt treatment with prednisone resolved symptoms, highlighting the importance of considering this diagnosis.

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Area of Science:

  • Vascular Medicine
  • Rheumatology
  • Pathology

Background:

  • Giant cell arteritis, including temporal arteritis, is a systemic vasculitis primarily affecting medium and large arteries.
  • Ischemic manifestations can occur in various organs, but digital gangrene is an uncommon presentation.

Observation:

  • An 80-year-old male presented with gangrenous lesions on his left hand's phalanges and an elevated erythrocyte sedimentation rate (ESR).
  • Temporal artery biopsy revealed characteristic inflammation, confirming temporal arteritis.

Findings:

  • The patient's gangrenous lesions were amputated, and he was treated with high-dose prednisone (60 mg/day).
  • At 12-month follow-up, there was no recurrence of ischemic symptoms, and ESR normalized, indicating successful treatment.

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Implications:

  • Digital gangrene combined with elevated ESR should prompt consideration of temporal arteritis in the differential diagnosis.
  • Early diagnosis and treatment of temporal arteritis are crucial to prevent irreversible ischemic damage and complications.