Recurrent Stroke in Giant Cell Arteritis Despite Immunotherapy.
Neurologist
; 24(4): 139-141, 2019 Jul.
Article
en En
| MEDLINE
| ID: mdl-31246724
ABSTRACT
OBJECTIVE:
To describe rare but important cerebrovascular complications of giant cell arteritis (GCA). CASE REPORT We report a 59-year-old man who initially presented with vasculitis of the lower extremities. While on steroids, he developed strokes in multiple vascular territories. The conventional angiogram showed stenosis of bilateral carotid and vertebral vessels as they entered the dura. Temporal artery biopsy confirmed GCA. He began cyclophosphamide treatment, which stabilized his clinical course; however, this was switched to tocilizumab by an outside rheumatologist. Two months later, the patient had progression of vessel stenosis and suffered additional strokes. Despite interventions to augment cerebral perfusion, the infarctions continued to expand and the patient passed away.CONCLUSIONS:
This case highlights several important features of strokes in GCA the predilection for the dural entry point of cerebral blood vessels, the progression of disease despite steroids, and the need to quickly escalate treatment in these cases. As seen in our patient, however, this disease carries high morbidity and mortality and patients often have poor outcomes despite aggressive immunosuppression.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Arteritis de Células Gigantes
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Accidente Cerebrovascular
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Ciclofosfamida
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Anticuerpos Monoclonales Humanizados
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Inmunosupresores
Límite:
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Neurologist
Asunto de la revista:
NEUROLOGIA
Año:
2019
Tipo del documento:
Article
País de afiliación:
Mongolia