Temporal arteritis associated with Chlamydia pneumoniae DNA detected in an artery specimen.
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Chlamydophila Infections↗
Biomedical subjects
R Bie
Publications and source records attributed to R Bie.
Chlamydia pneumoniae not detected in temporal artery biopsies from patients with temporal arteritis.
In a recent report Chlamydia pneumoniae (C. pneumoniae), examined with both immunohistochemistry and polymerase chain reaction (PCR), was detected in positive temporal artery biopsies from patients with temporal arteritis (TA). Our aim was to examine whether C. pneumoniae could be detected in patients with TA recruited from a high endemic area of TA in southern Norway. Twenty paraffin-embedded temporal artery biopsies showing convincing inflammation in the vessel wall with lymphocytic infiltration (giant cells in 12 biopsies) from 20 patients with TA were examined for the presence of C. pneumoniae using an established PCR technique. All examined TA patients (mean age 74.4 (SD 7.5) years, 75% females) fulfilled the ACR-1990 criteria. C. pneumoniae was not detected in any of the biopsies. In conclusion, our results indicate that C. pneumoniae, at least in the population of southern Norway, does not have any pathogenetic role in TA.
Aged↗
[Renal crisis in systemic sclerosis].
Systemic sclerosis is a rare connective tissue disorder, potentially affecting several internal organs. Renal disease is seen in 10-40% of the cases, while autopsy studies have shown interstitial renal changes in as many as 80%. Renal involvement is clinically divided into two separate forms; chronic and acute nephritis. Acute nephritis in a patient suffering from systemic sclerosis is termed renal chrisis, and is associated with high morbidity and mortality. Renal crisis in systemic sclerosis is discussed based on a case report and a review of the literature. Treatment with ACE-inhibitors has dramatically improved the prognosis of this complication. Careful surveillance of patients at risk, especially patients with the diffuse type of systemic sclerosis and showing antibodies against RNA-polymerase, as well as early treatment is considered important for the outcome.
Acute Kidney Injury↗
Primary vasculitis in a Norwegian community hospital: a retrospective study.
Primary systemic vasculitic diseases are relatively rare. Untreated, they have a high morbidity and mortality. The introduction of steroids and cytotoxic drugs has dramatically reduced the mortality. In a retrospective study in a Norwegian community hospital, which serves a county with a population of 150,426 in 1996, 68 patients were found to have a primary vasculitis, 63 of whom fulfilled the ACR 1990 criteria. Patients with Henoch-Schönlein purpura aged less than 16 years and patients with Kawasaki's disease were excluded. The overall prevalence was 43.9 per 100,000 inhabitants (Churg-Strauss syndrome 1.3, hypersensitivity vasculitis 2.7, Henoch-Schönlein purpura 3.3, polyarteritis nodosa 3.3, Wegener's granulomatosis 5.3 and temporal arteritis 27.9). In most cases, disease control was achieved with corticosteroids alone, or with the addition of cytotoxic drugs. Two patients had died in the latest 5-year period but of unrelated disorders. Biopsy plays a major role in diagnosing vasculitic diseases. In our study, 62 patients had a positive biopsy supporting the diagnosis.
Adolescent↗
Vasculitic changes in the temporal artery in polyarteritis nodosa.
In a retrospective study of primary vasculitis in a Norwegian community hospital 6 patients were found to have polyarteritis nodosa (PAN). Five of them had taken a temporal artery biopsy and in all biopsies vasculitic changes were found, but no giant cells. Muscle biopsies from each of the patients showed the same major vasculitic changes as in the temporal artery. The histopathological findings could not exclude temporal arteritis (TA). None of the 5 polyarteritis patients who all fulfilled the ACR 1990 criteria had a case history typical for TA. Our results give the impression that vasculitic changes in the temporal artery may be a frequent finding in PAN. An atypical case history of TA with vasculitis in the temporal artery without giant cells and atypical histopathological findings should lead to the suspicion of PAN or another primary vasculitis. We also recommend a temporal artery biopsy in all cases of suspected PAN.
Aged↗