Most of temporal arteritis occurs in the older patient over 50 years old, and the histopathologic finding shows a granulomatous inflammation, so this called giant cell arteritis. However, the young patients also present with a nodular lesion in their temple, and juvenile temporal arteritis (JTA) should be considered as one of the differential diagnosis, although it is very rare. For both diagnosis and treatment of JTA, excisional biopsy is essential. The pathologic finding of the temporal artery shows panarteritis with lymphoeosinophilic infiltrates, but no giant cell or granulomatous lesion. JTA is a localized disease with low level of systemic inflammatory marker, so the symptom is usually relieved by excision of affected lesion. Peripheral blood eosinophilia present in some cases of JTA, but its relation with clinical course and prognosis is not yet been known. Herein, we report the case of a 24-year-old man diagnosed with concurrent JTA and hypereosinophilic syndrome. We also reviewed the literature of JTA focusing on the impact of combined peripheral eosinophilia on the course of the disease. Combined peripheral eosinophilia may increase the risk of recurrence of JTA after local treatment such as excision only.
Biopsy ; Diagnosis ; Diagnosis, Differential ; Eosinophilia ; Giant Cell Arteritis ; Giant Cells ; Humans ; Hypereosinophilic Syndrome ; Inflammation ; Prognosis ; Recurrence ; Temporal Arteries ; Young Adult

BACKGROUND: Polymyalgia rheumatica (PMR) is a common systemic inflammatory disease of the elderly; however, the clinical characteristics and therapeutic response of PMR in Korea have been rarely studied. METHODS: We reviewed the medical records of 54 Korean patients diagnosed with PMR between January 2009 and February 2017 in a locomotive pain clinic of one tertiary referral hospital. We analyzed epidemiologic and clinical characteristics, therapeutic responses, and prognostic factors for remission-failure at one-year after oral prednisolone treatment. RESULTS: In 54 patients with PMR, 32 (59.3%) were female. The average age at diagnosis was 65.0 ± 10.5 years. Duration of symptoms before diagnosis was 8.1 ± 8.6 months. All patients had shoulder pain (54 patients, 100.0%); 49 patients (90.7%) had hip girdle pain, while 19 patients (35.2%) had peripheral joint pain. Four patients (7.4%) were accompanied by the giant cell arteritis (GCA). There was no seasonal preference for symptom development. Only 19 patients were diagnosed with PMR at initial symptom presentation. At one-year follow-up after oral prednisolone treatment, the remission rate was 35.3% (12/34). Multivariate analysis showed that history of relapse (odds ratio, 6.81; 95% confidence interval, 1.035–44.804) was a significant predictor of remission-failure. CONCLUSION: The rate of remission (35.3%) after oral prednisolone treatment was similar to previous reports in western countries; and GCA is not a rare condition in Korean PMR patients. Misdiagnosis of PMR is common, and heightened consideration for PMR is needed in elderly patients who present inflammatory features of bilateral shoulder pain.
Aged ; Arthralgia ; Cohort Studies* ; Diagnosis ; Diagnostic Errors ; Female ; Follow-Up Studies ; Giant Cell Arteritis ; Hip ; Humans ; Korea ; Medical Records ; Multivariate Analysis ; Pain Clinics* ; Polymyalgia Rheumatica* ; Prednisolone ; Recurrence ; Seasons ; Shoulder Pain ; Tertiary Care Centers ; Treatment Outcome

No abstract available.
Giant Cell Arteritis* ; Giant Cells* ; Headache* ; Optic Neuropathy, Ischemic*

Juvenile temporal arteritis (JTA) is a localized nodular arteritis confined to the temporal artery without evidence of systemic inflammation, and it occurs mainly in patients younger than 50 years. From the first case report, the pathological features of JTA have been suspected to be the morphological equivalent of Kimura disease (KD), which has been supported further by the concurrent cases of JTA with KD. We present the first case of bilateral JTA accompanying KD, which was confirmed by histological and ultrasound evaluations and supports the hypothesis that JTA is a manifestation of KD. The un-excised JTA lesion was resolved completely after corticosteroid therapy with no recurrence.
Adrenal Cortex Hormones ; Angiolymphoid Hyperplasia with Eosinophilia ; Arteritis ; Giant Cell Arteritis ; Humans ; Inflammation ; Recurrence ; Temporal Arteries ; Ultrasonography

No abstract available.
Giant Cell Arteritis* ; Giant Cells* ; Korea* ; Optic Neuropathy, Ischemic*

Giant cell arteritis (GCA) is categorized as vasculitis of the large and medium-sized vessels. Visual loss is one potential consequence of cranial arteritis. Temporal artery biopsies are performed frequently to demonstrate the involvement of arteritis. On the other hand, cerebral artery involvement with pathological findings is not well documented in patients with GCA. We report a rare case of GCA with cerebral vessel involvement in a 76-year-old woman.
Aged ; Arteritis ; Biopsy* ; Brain* ; Cerebral Arteries ; Female ; Giant Cell Arteritis* ; Giant Cells* ; Hand ; Humans ; Temporal Arteries ; Vasculitis

No abstract available.
Aged ; Giant Cell Arteritis/*complications/diagnosis ; Humans ; Male ; Optic Neuropathy, Ischemic/diagnosis/*etiology ; Republic of Korea ; Temporal Arteries/diagnostic imaging ; Ultrasonography ; *Visual Acuity

Giant cell arteritis (GCA) is a systemic vasculitis which typically occurs in persons over 50 years old. GCA is closely related to polymyalgia rheumatica (PMR). A temporal artery biopsy is the gold standard test for the diagnosis of GCA. Recently, there is increasing evidence for the role of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in diagnosis of vasculitis. Here, we report on a case of a 67-year-old Korean male who was diagnosed with atypical GCA in subclinical stage concomitant with PMR by 18F-FDG-PET. After treatment, abnormal findings of 18F-FDG-PET were improved.
Aged ; Biopsy ; Diagnosis ; Giant Cell Arteritis* ; Giant Cells* ; Humans ; Male ; Polymyalgia Rheumatica ; Positron-Emission Tomography ; Systemic Vasculitis ; Temporal Arteries ; Vasculitis

Aortic complications of giant cell arteritis are a rare cause of abdominal aortic aneurysm. Here, we describe a case of a ruptured aortic aneurysm in a patient with giant call arteritis (GCA) who was preoperatively suspected of having an infectious aortic aneurysm. Intraoperative inspection revealed infectious granulation tissue on the anterior wall of the abdominal aorta. GCA was finally confirmed by pathological diagnosis. Our findings suggest that the surgical and postoperative treatment of nonatheromatous aortic aneurysm should be based on accurate diagnosis.
Aorta, Abdominal ; Aortic Aneurysm ; Aortic Aneurysm, Abdominal* ; Aortic Rupture ; Aortitis ; Arteritis ; Diagnosis ; Giant Cell Arteritis* ; Giant Cells* ; Granulation Tissue ; Humans

A 38-year-old man was admitted to the hospital because of abrupt left flank pain. He had no fever and physical examination revealed tenderness of the left costovertebral angle. Laboratory data revealed white blood cell 16,060/microL, C-reactive protein 0.93 mg/dL. Urinalysis showed more than 1/2 red cells per high-power field with severe proteinuria (4+). Enhanced computed tomography (CT) showed the thickened abdominal aorta wall with partial thrombus. The thickened aorta wall compressed the left renal vein and it caused left renal vein thrombosis. Abdominal CT findings suggested aortitis of the abdominal aorta with complication of left renal vein. We could exclude other types of aortitis including autoimmune aortitis, Takayasu's arteritis, giant cell arteritis, and infectious causes based on a serologic test and the history of the patient. Therefore, the patient was diagnosed with idiopathic aortitis and treated with glucocorticoid. After treatment, his symptoms disappeared and a follow-up CT showed decreased mural thickening of the abdominal aorta. Isolated idiopathic aortitis presented with renal vein thrombosis is extremely rare and has not been reported in Korea yet. We present a rare case report on idiopathic aortitis of the abdominal aorta with complication of left renal vein thrombosis.
Adult ; Aorta ; Aorta, Abdominal ; Aortitis* ; C-Reactive Protein ; Fever ; Flank Pain ; Follow-Up Studies ; Giant Cell Arteritis ; Humans ; Inflammation ; Korea ; Leukocytes ; Physical Examination ; Proteinuria ; Renal Veins* ; Serologic Tests ; Takayasu Arteritis ; Thrombosis* ; Tomography, X-Ray Computed ; Urinalysis