Atipik Klinik Prezentasyonlu Bir Temporal Arterit Olgusu

Öz

Dev hücreli arterit olarak da bilinen temporal arterit, orta-büyük çaplı arterleri etkileyen enflamatuar bir hastalıktır. Her ne kadar birçok lokalizasyondaki arterleri etkileyebilen sistemik bir hastalık olsa da, karakteristik olarak başta temporal arter olmak üzere karotis arterinin bir veya daha fazla dalını tutar. Altmışbir yaşında erkek hasta kliniğimize baş ağrısı, şiddetli kulak çınlaması, halsizlik, terleme ve kilo kaybı şikayetleriyle başvurdu. Fizik muayenede bilateral submandibuler lenfadenopati ve hepatosplenomegali belirlendi. Temporal arter biyopsisinde “dev hücreli arterit (temporal arterit)” tanısı konuldu. Olgunun atipik prezentasyonu ve erken tanı ve tedavinin önemi nedeniyle sunmaya karar verdik. Anahtar kelimeler: Temporal arterit, Tinnitus, Lenfadenopati, Hepatosplenomegali

Anahtar Kelimeler

• Temporal arterit, Tinnitus, Lenfadenopati, Hepatosplenomegali

A Case of Temporal Arteritis with Atypical Clinical Presentation

Öz

Temporal arteritis also known as giant cell arteritis, is an inflammatory disease affecting medium- and large-sized arteries. Although, it is a systemic disorder that could affect arteries in multiple locations, it characteristically involves one or more branches of carotid artery particularly the temporal artery. 61 year-old male patient referred to our clinic by the complaints of headache, marked tinnitus, weakness, sweating and weight loss. Physical examination revealed bilateral submandibular lymphadenopathy and hepatosplenomegaly. Temporal artery biopsy confirmed the diagnosis of “giant cell arteritis (temporal arteritis)”. We decided to present this case because of its atypical presentation and importance of early diagnosis and therapy. Key words: Temporal arteritis, Tinnitus, Lymphadenopathy, Hepatosplenomegaly

Anahtar Kelimeler

• Temporal arteritis, Tinnitus, Lymphadenopathy, Hepatosplenomegaly

Kaynakça

1. Sneller MC, Langford CA, Fauci AS. The Vasculitis Syndromes. In Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL, Jameson JL (eds). Harrison’s Principles of Internal Medicine. 16th Edition, Part: XIII, Ch: 306, McGRAW – HILL Co. New York 2005; pp: 2002-14.
2. Panayi GS. Polymyalgia Rheumatica. In Maddison PJ, Isenberg DA, Woo P, Glass DN (eds). Oxford Textbook of Rheumatology, 2nd edition, Volume 2, Part V, Ch: 5.11.5, Oxford University Press 1998; pp: 1373-13
3. Rahman W, Rahman FZ. Giant cell (temporal) arteritis: an overview and update Surv Ophthalmol 2005; 50(5): 415-28
4. Salvarani C, Cantini F, Boiardi L, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. N Engl J Med 2002; 347(4): 261-71.
5. Amor-Dorado JC, Llorca J, Garcia-Porrua C, Costa C, Perez-Fernandez N, Gonzalez- Gay MA. Audiovestibular manifestations in giant cell arteritis: a prospective study. Medicine (Baltimore) 2003; 82(1): 13-26.
6. Wolfovitz E, Levy Y, Brook JG. Sudden deafness in a patient with temporal arteritis. J Rheumatol 1987;14(2): 384-5.
7. Kramer MR, Nesher G, Sonnenblick M. Steroid-responsive hearing loss in temporal arteritis. J Laryngol Otol 1988; 102(6):524-5.
8. Hu Z, Yang Q, Yang L, Li J, Tang J, Zhang H. Cerebral infarction due to giant cell arteritis. three case reports. Angiology 2004; 55(2): 227-31.