Chest
Selected ReportsPulmonary Artery Obstruction due to Giant Cell Arteritis
Section snippets
CASE REPORT
A 77-year-old Caucasian woman was admitted for evaluation of progressive dyspnea, fatigue, weakness and right-sided chest pain without fever over approximately six months, with no history of chronic headaches or muscle pain to suggest polymyalgia rheumatica. Physical examination disclosed an elderly woman in no acute distress, blood pressure 90/60 mm Hg, pulse 110 bpm and regular, mild jugular vein distention to 12 ml water, a two-over-six systolic ejection murmur at the lower left sternal
DISCUSSION
Giant cell arteritis is an idiopathic inflammatory process involving the large and medium-sized arteries. Involvement of the pulmonary artery has been reported,6 but pulmonary artery obstruction due to giant cell arteritis has not been previously described.
Symptoms occurred late in our patient and thromboembolism was most likely due to severely-reduced pulmonary blood flow. Our case is somewhat unusual in that extensive involvement of the pulmonary arteries without extensive aortic involvement
ACKNOWLEDGMENT
Our thanks to Caron Patnode for typing this manuscript.
REFERENCES (6)
- et al.
Giant cell arteritis and polymyalgia rheumatica
Clin Rheum Dis
(1985) - et al.
Giant cell arteritis of coronary arteries causing myocardial infarction
Br Heart J
(1980) - et al.
Aortic arch arteritis in the elderly: an important manifestation of giant cell arteritis
Arch Intern Med
(1986)
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Vasculitis in the intensive care unit
2013, Best Practice and Research: Clinical RheumatologyCitation Excerpt :In contrast to Takayasu's arteritis, GCA rarely is associated with pulmonary involvement [54]. While case reports of pulmonary infarction [55], pulmonary artery aneurysm [56], pulmonary hypertension with right-heart failure [57], pulmonary nodules [58] and interstitial or restrictive lung disease [59] exist, these manifestations are uncommon, and should trigger a broader diagnostic evaluation [54]. Pulmonary capillaritis is a life-threatening manifestation of small-vessel vasculitis [60,61].
Vasculitic Syndromes other than Wegener's Granulomatosis
2004, Handbook of Systemic Autoimmune DiseasesCitation Excerpt :Cavitating and non-cavitating multiple large nodular opacities (Bradley et al., 1984; Kramer et al., 1987) and interstitial opacities (Kramer et al., 1987; Karam and Fulmer, 1982) have been demonstrated on both transbronchial and open lung biopsy (Bradley et al., 1984; Karam and Fulmer, 1982). Pulmonary artery involvement has been noted in GCA (Dennison et al., 1985; Glover et al., 1987) and pulmonary arteriole and venule involvement has also been noted in a patient 6 months before the diagnosis of GCA (biopsy proven) was made (Doyle et al., 1988). When the disease is untreated the prognosis is poor but treated early, the prognosis is good.
Pulmonary vasculitis
1998, Clinics in Chest MedicinePulmonary involvement in common rheumatologic diseases in the elderly
1997, Immunology and Allergy Clinics of North AmericaThrombose réversible de l’artère pulmonaire
1995, Revue de Medecine InternePulmonary infarction caused by giant-cell arteritis of the pulmonary artery
1995, Netherlands Journal of Medicine