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[Polymyalgia rheumatica: a systemic vasculitis. Review of the literature and presentation of 2 clinical cases].

A brief historical account of the nosological and pathogenetic classification of rheumatic polymyalgia (RPM) is followed by an indication of the importance of vasculitis during its course. Elective involvement of the temporal artery is not always observed, though there may also, or exclusively, be involvement of other arterial districts, such as those of the subaxillary and subclavicular, that of the thoracic and abdominal aorta, and of the large branches of the lower limbs. Two clinical cases are presented in support of these assertions. It is also shown that arteritis may appear several months after the onset of RPM, and that its progress may be quite separate from that of the latter. Doppler examination is now of assistance in the diagnosis of these forms, since it permits exploration of the various districts and the detection of subclinical lesions. It is also useful in the monitoring of arteritis and its response to treatment.

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Circulating soluble adhesion molecules in systemic vasculitis.

The plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1), E-selectin (sE-selectin), and vascular cell adhesion molecule-1 (sVCAM-1), might reflect endothelial activation and injury and would therefore be useful markers of disease activity in vasculitis. To investigate this we measured the levels of sICAM-1, sE-selectin, and sVCAM-1 by two-site ELISAs in the plasma of patients with (a) active vasculitis (n = 16), (b) vasculitis in remission (n = 15), (c) chronic renal failure (CRF) (n = 10), and (d) normal healthy controls (n = 10). Plasma sICAM-1 levels were significantly higher in patients with active vasculitis, 323 ng/ml (193-607) compared with patients with inactive vasculitis, 199 ng/ml (131-297); P = 0.0006 and healthy controls, 188 ng/ml (138-259); P = 0.0002. Plasma sE-selectin levels were also significantly higher in the patients with active vasculitis, 45 ng/ml (15-65) compared with patients with inactive vasculitis, 25 ng/ml (15-55); P = 0.027 but not when compared with healthy controls, 35 ng/ml (20-55); P = 0.16. There was no difference in plasma sVCAM-1 levels between patients with active vasculitis, OD 0.56 (0.45-0.85) and inactive disease, OD 0.58 (0.47-0.79) (P = 0.12) or with healthy controls OD 0.49 (0.42-0.68) (P = 0.48). There were no significant differences between the plasma levels of any of the soluble adhesion molecules between patients with active vasculitis and patients with chronic failure.(ABSTRACT TRUNCATED AT 250 WORDS)

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