Abstract
Giant cell arteritis is more common in women older than 60 years, is associated with systemic inflammation symptoms and mainly involves the aortic arch and cranial arteries, specially the temporal artery. Symptomatic lower extremity arterial stenosis or occlusion is uncommon and can lead to limb loss. We report a 73-year-old woman presenting with a one-month history of lower extremity intermittent claudication of sudden onset. She also complained of fever, malaise, headache and weight loss. A non-invasive vascular study showed moderate femoral popliteal occlusive disease, with and abnormal ankle-brachial index (0.68 and 0.83 on right and left sides, respectively). An angio-computed tomography showed thickening of the aortic wall and severe stenosis in both superficial femoral arteries. Steroidal treatment was started, and a temporal artery biopsy was performed confirming giant cell arteritis. Six weeks after steroid therapy the patient had a complete remission of symptoms. A serologic exacerbation was subsequently treated with a humanized monoclonal antibody against the interleukin-6 receptor Tocilizumab, obtaining long time remission.
Highlights
Giant cell arteritis is more common in women older than 60 years, is associated with systemic inflammation symptoms and mainly involves the aortic arch and cranial arteries, specially the temporal artery
Por sospecha de enfermedad embólica secundaria a endocarditis infecciosa se inicia anticoagulación con enoxaparina y se realizó ecocardiografía transesofágica sin hallazgos sugerentes de vegetaciones
La isquemia de extremidades inferiores secundario a arteria temporal (AAT) es una entidad clínicamente poco frecuente que requiere de una alta sospecha en pacientes con claudicación intermitente aguda asociada a un cuadro inflamatorio sistémico, por esto último se debe descartar una embolía secundaria a endocarditis
Summary
Isquemia de extremidades inferiores secundaria a arteritis de la arteria temporal Cristian Zárate B.1, María Eugenia Martínez R-E.2, Pedro Sfeir V.1, Obren Drazic B.1, José F Vargas S.1, José I. We report a 73-year-old woman presenting with a one-month history of lower extremity intermittent claudication of sudden onset. She complained of fever, malaise, headache and weight loss. La arteritis de la arteria temporal (AAT) pertenece a la familia de las arteritis de células gigantes (ACG) y es la vasculitis sistémica más frecuente en adultos, afectando principalmente a la población femenina mayor de 50 años con un peak de incidencia a los 80 años[1].
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