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Showing posts from April 29, 2008

Temporal arteritis- Pathology

Most common form of vasculitis. Affects females more than males. Primarily affects the elderly population. Temporal arteritis is associated with HLA-DR4 Distribution of the disease: 1. Small and medium sized arteries 2. Cranial arteries (temporal, facial and ophthalmic arteries) 2. Aortic arch-giant cell aortitis (uncommon) Clinical features: 1. Throbbing headache- Mostly unilateral 2. Tender firm temporal arteries 3. Visual disturbances- Blurred vision, double vision, visual loss. 4. Facial pain 5. Fever, Malaise, Weight loss, muscle aches, anemia 6. Polymyalgia rheumatica: systemic flu like symptoms and joint involvement (pain, morning stiffness in neck, shoulders and hips). Laboratory findings- Elevated ESR Pathology- 1. Segmental granulomatous vaculitis 2. Fragmentation of internal elastic lamina 3. Intimal fibrosis with luminal narrowing. Diagnosis- Temporal arterial biopsy, classical presentation or rapid onset may be treated empirically Treatment - Corticosteroids