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首页> 外文期刊>The Journal of rheumatology >Bilateral optic nerve sheath enhancement from giant cell arteritis.
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Bilateral optic nerve sheath enhancement from giant cell arteritis.

机译：巨细胞动脉炎导致双侧视神经鞘膜增强。

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摘要

An 83-year-old man presented with acute bilateral visual loss to no light perception (NLP) OD and 20/50 OS. His fundus examination showed moderate bilateral pallid disc edema. A sedimentation rate was 60 mm/h. Magnetic resonance imaging of the brain and orbits with gadolinium revealed marked bilateral enhancement of the optic nerve sheaths and adjacent orbital fat. He underwent biopsies of the optic sheath OD and bilateral temporal arteries. Histopathology of the optic nerve sheath area revealed fibroadipose tissue containing numerous arteries with intimal thickening, and mild mural inflammation consisting predominantly of lymphocyte with occasional giant cells. The bilateral temporal artery biopsies revealed focal disruption of the elastic lamina with rare giant cells. His vision had since stabilized on IV methypdnisolone therapy. The biopsies of the nerve sheath suggest that the radiologic finding of optic nerve sheath enhancement in giant cell arteritis is caused by tbe same pathophysiology, and therefore may be a manifestation of this systemic disease.
机译：一名83岁的男性出现急性双侧视力丧失，无光感（NLP）OD和20/50 OS。他的眼底检查显示中度双侧苍白盘水肿。沉降速度为60mm / h。 and对大脑和轨道的磁共振成像显示，视神经鞘管和邻近的轨道脂肪明显增强。他接受了视神经鞘管外伤和双侧颞动脉的活检。视神经鞘管区域的组织病理学检查显示，纤维脂肪组织包含许多动脉，内膜增厚，轻度壁炎症反应主要由淋巴细胞和偶尔的巨细胞组成。双侧颞动脉活检显示稀有巨细胞的弹性层的局灶性破坏。此后，他的视力在静脉注射甲基甲泼尼龙治疗中趋于稳定。神经鞘的活检表明巨细胞性动脉炎中视神经鞘增强的放射学发现是由相同的病理生理引起的，因此可能是这种全身性疾病的表现。

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