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題名 | 巨細胞動脈炎頭痛之病例報告=Headache Attributed to Giant Cell Arteritis--A Case Report |
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作者姓名(中文) | 黃子洲; 王博仁; | 書刊名 | 臺灣老年醫學暨老年學雜誌 |
卷期 | 6:4 2011.11[民100.11] |
頁次 | 頁259-267 |
分類號 | 417.7842 |
關鍵詞 | 巨細胞動脈炎; 顳動脈炎; 老年頭痛; Giant cell arteritis; Temporal arteritis; Geriatric headache; |
語文 | 中文(Chinese) |
中文摘要 | 巨細胞動脈炎 (giant cell arteritis, GCA) 是一種肉芽腫性的血管發炎,特別常侵襲中型動脈,尤其是顳動脈 (temporal artery),因此又被稱為顳動脈炎。有別於其它常見的血管發炎性的疾病, GCA較常侵犯年紀超過 50歲的中老年人,在台灣是屬於較為少見的疾病。病患常見的症狀包括頭痛、倦怠、肌肉疼痛、視覺障礙等,多屬於非特異性的主訴,但是嚴重時如果延遲治療,有可能導致永久失明。診斷時最主要的依據是新發生的頭痛,視診及觸診發現顳動脈異常,輔以實驗室檢查如紅血球沉降速率、 C-反應蛋白等,而最終的診斷則是顳動脈切片檢查,由病理診斷確認。治療目前的首選仍是類固醇,在一定時間的用藥後,通常可以痊癒。我們報告一個 GCA的個案,雖其顳動脈切片並未見到發炎的病理變化,但其臨床症狀、病程和實驗室數據均支持 GCA的診斷,也符合美國風濕免疫醫學會 (American College of Rheumatology) 和國際頭痛學會 (International Headache Society)制定的診斷準則,而且經類固醇治療 7週後病情獲得緩解。對於老年人新發生的頭痛,須注意顳動脈發炎的可能。 |
英文摘要 | Giant cell arteritis (GCA) or temporal arteritis is a granulomatous vasculitis involving medium-sized arteries. It affects individuals over 50 years of age. Its clinical symptoms include headache, malaise, myalgia and visual problem. It may result in serious outcomes such as blindness. New onset headache, engorged temporal artery and laboratory examination suggest the diagnosis. Temporal artery biopsy is the definite way to make diagnosis. Steroid remains the most effective treatment for GCA. We present a case, whose headache, clinical course and laboratory findings suggest GCA. He met the American College of Rheumatology and International Headache Society criteria for GCA although temporal artery biopsy showed negative results. The patient had relatively mild inflammatory symptoms. He became symptom-free after steroid treatment for 7 weeks. GCA should be taken into consideration in treating elderly patients with unilateral new-onset headache. |
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