你从来没有想过巨细胞关节炎
Natalia Shor1, David Saadoun2, Valérie Touitou3
1Department of Neuroradiology, Pitié-Salpêtrière Hospital, Sorbonne University, Paris, France.
Ocular immunology and inflammation
|November 3, 2025
概括
巨细胞动脉炎 (GCA) 的诊断可能很困难,特别是正常的C反应蛋白 (CRP) 水平. 这一案例凸显了在患有偏中心急性中间黄斑病 (PAMM) 的老年患者中考虑GCA的重要性,即使是阴性CRP.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 血管医学 血管医学
背景情况:
- 巨细胞动脉炎 (GCA) 的诊断可能具有挑战性,特别是当C反应性蛋白 (CRP) 水平没有升高时.
- 偏中心急性中间斑点病变 (PAMM) 是一种眼睛发现,可以存在于GCA.
- 动脉动脉炎的GCA往往呈现系统性炎症症状,在某些情况下可能不存在.
研究的目的:
- 报告一个具有挑战性的GCA诊断病例.
- 强调在非典型发现的情况下对GCA的诊断考虑.
主要方法:
- 一个73岁的男性患者的病例报告.
- 用上门CT扫描和PET扫描进行诊断.
- 评估了患者表现,包括单边的偏中心急性中间巨病 (PAMM) 和内动脉狭窄.
主要成果:
- 这位患者出现了单边的偏中心急性中间巨病 (PAMM) 和同侧内动脉狭窄.
- 记录了两个阴性C反应蛋白 (CRP) 测试.
- 通过在CT扫描上检测扩散性主动脉炎和在PET扫描上检测关节动脉炎来确认GCA的诊断.
结论:
- 在患有PAMM的老年患者中,高程度的GCA怀疑至关重要,即使是阴性CRP.
- "动脉动脉炎GCA"可能并不总是与明显的炎症症状有关.
- 这一案例强调了全面成像在诊断GCA时的重要性,当临床表现异常时.
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