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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...

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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
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大血管参与ANCA相关的血管炎:一个多中心病例控制研究.

V Monghal1, X Puéchal2, P Smets1

  • 1Médecine Interne, Centre Hospitalier Universitaire Gabriel-Montpied, 63000 Clermont-Ferrand, France.

Seminars in arthritis and rheumatism
|May 29, 2024
PubMed
概括

抗中性人细胞质抗体 (ANCA) 相关血管炎 (AAV) 的大血管参与 (LVI) 是罕见的,但与神经问题有关. 标准的AAV治疗对于管理LVI.有效.

关键词:
与ANCA相关的血管炎大动脉的大动脉.大型船只的参与.神经学的参与 神经学的参与

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科学领域:

  • 类风湿病学 类风湿病学
  • 血管医学 血管医学
  • 免疫学 免疫学 免疫学

背景情况:

  • 抗中性细胞质抗体 (ANCA) 相关的血管炎 (AAV) 通常影响小血管.
  • 大血管卷入 (LVI) 是AAV的一种不常见但显著的表现.

研究的目的:

  • 在AAV患者中描述LVI.
  • 为了确定与LVI相关的风险因素.
  • 描述LVI的治疗管理.

主要方法:

  • 进行了一项多中心病例控制研究 (1:2比).
  • 患者符合AAV的ACR/EULAR分类标准和LVI的Chapel Hill分类标准.
  • 对照组根据年龄,性别和AAV类型进行了匹配.

主要成果:

  • 包括26名患有LVI的AAV患者,主要是带有多层炎的粒状瘤.
  • 主动脉是最常受到影响的血管 (69%),其次是上大动脉干 (35%).
  • 严重的LVI与神经症状有显著的关联 (OR=3.23) 但不是心血管风险因素或AAV复发.

结论:

  • 应该考虑LVI是AAV的潜在表现,主动脉通常受到影响.
  • 在AAV的神经参与可能会增加患LVI的风险.
  • 标准治疗AAV,包括皮质类固醇和免疫抑制剂 (cyclophosphamide,rituximab),是有效的管理LVI.