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Lege Artis Medicinae

SEPTEMBER 15, 2006

[TAKAYASU’S ARTERITIS DETECTED IN AN EARLY PHASE]

SZÁNTÓ Antónia, VEISZ Richárd, KRENÁCS László, CSIKI Zoltán, GRIGER Zoltán, ZEHER Margit

[INTRODUCTION - Takayasu’s arteritis is an idiopathic inflammatory disease of the great elastic arteries, mainly of the aorta and its primary branches. It primarily affects young women. CASE REPORT - A 20-year-old woman presented with general inflammatory symptoms that had begun 3 to 4 months before. Earlier she underwent a biopsy from a mass on the neck thought to be a lymph node, which on histopathological examination turned out to be a non-necrosing granulomatosis in the wall of a large artery. Based on this finding as well as on the presence of fever, weight loss, carotid murmur, anaemia, elevated platelet count, increased sedimentation rate, the lack of pulse and the findings of imaging examinations, Takayasu’s arteritis was diagnosed. Treatment was started with high-dose steroid monotherapy, which resulted in clinical and laboratory remission after a short time. The imaging findings (neck soft tissue sonogram and MRI) also showed improvement, however, a moderate but definite disease activity was still present, thus steroid treatment was supplemented with azathioprin. CONCLUSION - It is important to follow the disease both clinically and with imaging techniques for an early recognition of the need for changing or adjusting the treatment.]

Lege Artis Medicinae

FEBRUARY 20, 2005

[THE IMMUNPATHOGENESIS OF VASCULITIDES]

ZEHER Margit

[The vasculitides are clinicopathologic entities characterized by the inflammation and damage to blood vessels. Most vasculitic syndromes are mediated by immunopathogenic mechanisms. Most immune vasculitides are idiopathic (“primary vasculitis”) and systemic. The “immune vasculitides” are classified according to their hypersensitivity reaction types: allergic angiitis, antineutrophil cytoplasmic antibody (ANCA) -associated vasculitis, immunecomplex vasculitis, and vasculitis associated with T cell-mediated hypersensitivity. Immunological features: eosinophilia plus elevated IgE are characteristic of allergic angiitis and granulomatosis (Churg-Strauss syndrome). No immune deposits can be found in situ in ANCA associated vasculitis (“pauci-immune vasculitis”). Immune complex deposits, by contrast, are the hallmark of immune-complex vasculitis, which is frequently associated with low complement levels. Inflammatory infiltration induced by Th1 cells distinguishes vasculitis associated with T cell-mediated hypersensitivity (granulomatous arteritis). This article is dealing with the immunological mechanisms which may play a central role in the development of vasculitides.]

Lege Artis Medicinae

FEBRUARY 21, 2004

[LARGE VESSEL MANIFESTATION OF GIANTCELL ARTERITIS]

KOLOSSVÁRY Endre, PINTÉR Hajnalka, ERÉNYI Éva, KOLLÁR Attila, FARKAS Katalin, KISS István, HARCOS Péter, SIMON Károly

[The diagnosis of giant-cell arteritis is a real challenge for clinicians. There are several reasons for the difficulties in establishing the diagnosis. This disease is associated to rare conditions, therefore most physicians lack clinical experience. This condition shows very heterogeneous manifestation, the intensity of the symptoms vary in time. Early diagnosis is of great importance in order to prevent ischemic complications. Among these complications one should emphasise the role of anterior ischemic optic neuropathy that may result in abrupt blindness. In this case report, we show a rare socalled large vessel manifestation of giant-cell arteritis. This form of the disease needs different approach in diagnosis where color duplex ultrasonography may have distinguished importance. The final verification of the diagnosis is based on histology. However the lack of all histological criteria do not exclude the presence of giant-cell arteritis.]

Lege Artis Medicinae

FEBRUARY 21, 2004

[EYE DISORDERS ASSOCIATED WITH MUSCULOSKELETAL DISEASES]

VOGT Ferenc

[The diseases of connective tissue and musculoskeletal system frequently associated with typical eye disorders. These can either be mild, recovering fully after treatment or more serious with persisting symptoms and destructive changes resulting in permanent loss of sight Eye symptoms can occur in the following diseases: rheumatoid arthritis, juvenile chronic arthritis, neonatal onset multisystem disease, ankylosing spondylitis, seronegative spondarthrities, Reiter’s syndrome, Behçet’s syndrome, Lyme disease, systemic lupus erythematosus, scleroderma, polyarteritis nodosa, Wegener’s granulomatosis, giant cell arteritis, erythema nodosum, relapsing polychondritis, sarcoidosis, Marfan’s syndrome, osteogenesis imperfecta.]