Giant cell arteritis(GCA)is a vasculitis of medium and large sized vessels that occurs most often in people>50 years of age with associated symptoms of fever,weight loss,headache and jaw claudication.Polymyalgia rh...Giant cell arteritis(GCA)is a vasculitis of medium and large sized vessels that occurs most often in people>50 years of age with associated symptoms of fever,weight loss,headache and jaw claudication.Polymyalgia rheumatica(PMR),which is characterized by aching and stiffness in the shoulders,hip girdle,neck and torso,is intimately associated with GCA,and evidence suggests that GCA and PMR are two phases of the same disease.The occurrence of liver enzyme abnormalities in either of these conditions is rare.Furthermore,as these conditions occur most commonly in the elderly population who may be subject to polypharmacy,patients with elevated aminotransferases due to underlying GCA/PMR may mistakenly have their abnormal liver function tests attributed to drug-induced liver injury.Given the potential complications of these diseases if left untreated,including ischemic stroke and blindness,early recognition and treatment are critical.We report two patients who developed severe cholestatic liver enzyme elevation,which had been initially attributed to drug toxicity,but was ultimately caused by large vessel vasculitis,specifically GCA and PMR.展开更多
Gastrointestinal stromal tumors （GISTs） are rare neoplasms （1%） of the gastrointestinal tract and to our knowledge only rare cases of synchronous presentation of gastric carcinomas and GISTs are reported in the li...Gastrointestinal stromal tumors （GISTs） are rare neoplasms （1%） of the gastrointestinal tract and to our knowledge only rare cases of synchronous presentation of gastric carcinomas and GISTs are reported in the literature. A 72-year-old female with a simultaneous presentation of gastric adenocarcinoma and GIST is presented. Moreover, due to polymyalgia rheumatica the patient received corticosteroids as treatment for the last 3 years. The concomitant occurrence of these neoplasms may involve common carcinogenic factors and there could be an association with polymyalgia rheumatica either as a paraneoplastic presentation or due to its treatment with corticosteroids.展开更多
The aim of this observational study was to biochemically characterize the anaemia in GCA (giant cell arteritis) and PMR (polymyalgia rheumatica) patients. Values for mean corpuscular volume, mean corpuscular hemoglobi...The aim of this observational study was to biochemically characterize the anaemia in GCA (giant cell arteritis) and PMR (polymyalgia rheumatica) patients. Values for mean corpuscular volume, mean corpuscular hemoglobin and soluble transferrin receptor were normal, whereas serum iron and total iron binding capacity (TIBC) were subnormal, and mean ferritin was above the upper reference limit. Iron-restricted erythropoiesis (IRE), defined as a bone marrow smear staining positive for iron in combination with transferrin saturation less than 20%, was present in all patients. All patients exhibited clinical and biochemical signs of active inflammation with elevated C-reactive protein and an increased erythrocyte sedimentation rate.展开更多
文摘Giant cell arteritis(GCA)is a vasculitis of medium and large sized vessels that occurs most often in people>50 years of age with associated symptoms of fever,weight loss,headache and jaw claudication.Polymyalgia rheumatica(PMR),which is characterized by aching and stiffness in the shoulders,hip girdle,neck and torso,is intimately associated with GCA,and evidence suggests that GCA and PMR are two phases of the same disease.The occurrence of liver enzyme abnormalities in either of these conditions is rare.Furthermore,as these conditions occur most commonly in the elderly population who may be subject to polypharmacy,patients with elevated aminotransferases due to underlying GCA/PMR may mistakenly have their abnormal liver function tests attributed to drug-induced liver injury.Given the potential complications of these diseases if left untreated,including ischemic stroke and blindness,early recognition and treatment are critical.We report two patients who developed severe cholestatic liver enzyme elevation,which had been initially attributed to drug toxicity,but was ultimately caused by large vessel vasculitis,specifically GCA and PMR.
文摘Gastrointestinal stromal tumors （GISTs） are rare neoplasms （1%） of the gastrointestinal tract and to our knowledge only rare cases of synchronous presentation of gastric carcinomas and GISTs are reported in the literature. A 72-year-old female with a simultaneous presentation of gastric adenocarcinoma and GIST is presented. Moreover, due to polymyalgia rheumatica the patient received corticosteroids as treatment for the last 3 years. The concomitant occurrence of these neoplasms may involve common carcinogenic factors and there could be an association with polymyalgia rheumatica either as a paraneoplastic presentation or due to its treatment with corticosteroids.
文摘The aim of this observational study was to biochemically characterize the anaemia in GCA (giant cell arteritis) and PMR (polymyalgia rheumatica) patients. Values for mean corpuscular volume, mean corpuscular hemoglobin and soluble transferrin receptor were normal, whereas serum iron and total iron binding capacity (TIBC) were subnormal, and mean ferritin was above the upper reference limit. Iron-restricted erythropoiesis (IRE), defined as a bone marrow smear staining positive for iron in combination with transferrin saturation less than 20%, was present in all patients. All patients exhibited clinical and biochemical signs of active inflammation with elevated C-reactive protein and an increased erythrocyte sedimentation rate.
