rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2014-578-581rsp-1995Research ArticleНАБЛЮДЕНИЯ ИЗ ПРАКТИКИCLINICAL NOTESСлучай гигантоклеточного артериита, проявившегося дорсолатеральным медуллярным инфарктом мозгаTHE CASE OF THE GIANT-CELL ARTERITIS MANIFESTED AS DORSOLATERAL MEDULLARY INFARCTIONАкимовВ. С.AkimovV. S.vakimov@emcmos.ruАйвориМ. А.IvoryM. A.ЛищукС. В.LishchukS. V.ЖиляевЕ. В.ZhilyaevE. V.ЗАО «Юропиан Медикал Сентр», Москва, РоссияРоссияCJSC «European Medical Center», Moscow, RussiaRussian Federation201407102014525578581Copyright © Акимов В.С., Айвори М.А., Лищук С.В., Жиляев Е.В., 20142014Акимов В.С., Айвори М.А., Лищук С.В., Жиляев Е.В.Akimov V.S., Ivory M.A., Lishchuk S.V., Zhilyaev E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1995

Представлен случай гигантоклеточного артериита, первыми клиническими симптомами которого стали повышение температуры тела и развитие инфаркта в бассейне левой позвоночной артерии. По данныммагнитно-резонансной ангиографии выявлено ее протяженное сужение. В лабораторных данных обращало на себя внимание значительное увеличение СОЭ и повышение концентрации С-реактивного белка (СРБ) в крови. При направленном обследовании пациентки выявлено отсутствие пульсации на пальпируемых височных артериях. Диагноз подтвержден специфическими данными биопсии, включая обнаружение гигантских многоядерных клеток. На данном примере авторы обсуждают проблемы диагностики заболевания, роль лучевых методов (ультразвуковое ангиосканирование, магнитно-резонансная и компьютерно-томографическая ангиография, позитронно-эмиссионная томография) и необходимость настороженности в отношении лиц пожилого возраста со значительным увеличением СОЭ и повышенным уровнем СРБ.

The case of a giant-cell arteritis is presented. First clinical signs of the disease were fewer and development of infarction in the basin of the left vertebral artery. Magnetic resonance angiography showed its prolonged diminution. Laboratory results were remarkable for the high rate of erythrocyte sedimentation and the increase of C-reactive protein (CRP) concentration. Physical examination revealed acrotism in temporal arteries. Diagnosis was proven by biopsy results which included giant multinucleate cells. Authors discuss problems of diagnosis of the disease, the role of radiological methods (angio-ultrasonography, magnetic resonance and computed tomography aided angiography, positron-emission tomography) and the necessity to pay particular attention to the elderly patients with high rate of erythrocyte sedimentation and the increased CRP concentration.

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The authors declare that there are no conflicts of interest present.