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Revista médica de Chile · Oct 2020
[Lower limb ischemia in giant cell arteritis. Report of one case].
- Cristian Zárate B, María Eugenia Martínez R-E, Pedro Sfeir V, Obren Drazic B, José F Vargas S, José I Torrealba F, Michel Bergoeing R, Leopoldo Mariné M, Francisco Valdés E, and Renato Mertens M.
- Departamento de Cirugía Vascular y Endovascular, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Rev Med Chil. 2020 Oct 1; 148 (10): 1513-1517.
AbstractGiant 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.
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