巨细胞动脉炎表现为区域后端综合征:一个病例报告
Caitlin Courtney1, Catherine Franconi1, Ferry Dharsono2
1Neurology, Royal Perth Hospital, Perth, AUS.
Cureus
|October 31, 2025
概括
巨细胞动脉炎 (GCA) 可能导致区域后热综合征 (APS),导致严重的神经症状,如难治性恶心和吐. 早期诊断和用皮质类固醇和IL-6抑制剂治疗可以解决APS及其潜在的GCA原因.
科学领域:
- 神经学 神经学
- 血管神经学 血管神经学
- 类风湿病学 类风湿病学
背景情况:
- 区域后综合征 (APS) 的特征是恶心,吐和打,通常表明大脑干参与.
- 巨细胞动脉炎 (GCA) 是一种全身性血管炎,可以影响动脉,可能导致神经复杂症.
- 脊椎动脉狭窄是后部循环缺血事件的已知的危险因素.
研究的目的:
- 报告一种罕见的APS病例是GCA的次要病例.
- 以突出诊断挑战和治疗结果在这种情况下.
- 为GCA诱导的APS的有限文献做出贡献.
主要方法:
- 一个76岁的男性患有难以治愈的恶心,吐和打的病例介绍.
- 血管成像 (CTA/MRA) 显示脊椎动脉狭窄.
- 用于GCA诊断的正子发射断层扫描 (PET).
- 用皮质类固醇和托西利祖马布 (IL-6抑制剂) 治疗.
主要成果:
- 该患者出现了小脑和髓中风,包括区域前,双侧脊椎动脉狭窄.
- 炎症标志物升高表明GCA,PET成像证实了这一点.
- 用皮质类固醇和托西利祖马布治疗导致APS和GCA的解决.
结论:
- APS可能是GCA的不寻常表现,呈现出显著的胃肠道和神经系统症状.
- 多式成像和炎症标志物评估对于诊断与GCA相关的神经综合征至关重要.
- 包括IL-6抑制在内的向免疫抑制疗法可以有效地管理GCA诱导的APS.
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