両側頬部の腫脹と疼痛を主訴とした巨細胞動脈炎の1例

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  • A case of giant cell arteritis associated with bilateral cheek swelling and pain
  • リョウガワ ホオブ ノ シュチョウ ト トウツウ オ シュソ ト シタ キョサイボウ ドウミャクエン ノ 1レイ

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Giant cell arteritis (GA) is a rare disease among Japanese, and the cause is unknown. There are no previous reports of bilateral GA along the facial arteries. This report presents the case of a 69-year-old woman who was referred to this department because of swelling and intense pain in both cheeks. Antibiotics and nonsteroidal anti-inflammatory drugs were administered for 1 week, but the clinical symptoms worsened. The results of blood examinations and a CT scan suggested that the patient had arteritis, and treatment with 10 mg/day prednisolone was initiated. Then, swelling and pain developed along the temporal artery, and a 3D-CT angiogram of the head was taken. It showed mild linearization and variations in the diameter of both superficial temporal arteries. A biopsy of the temporal artery was then performed, and the histopathological diagnosis was GA. GA is often difficult to diagnose because of the wide range of general symptoms. However, it is important to diagnose and treat GA as soon as possible, because delayed diagnosis and treatment may result in blindness in severe cases involving the ophthalmic artery. GA should therefore be included in the differential diagnosis in patients with swelling and intense pain in the maxillofacial region despite treatment with antibiotics and nonsteroidal anti-inflammatory drugs.

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