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Clinical Rheumatology

, Volume 10, Issue 3, pp 294–297 | Cite as

Liver scan abnormalities in polymyalgia rheumatica/giant cell arteritis

  • V. Kyle
  • E. P. Wraight
  • B. L. Hazleman
Originals

Summary

Liver involvement in polymyalgia rheumatica/giant cell arteritis (PMR/GCA) before treatment and during follow-up of up to 3 1/2 years was assessed in 74 patients clinically, with liver function tests, isotope scans and blood flow studies. Twenty-seven patients had elevated alkaline phosphatase levels which fell to normal after 2.6 weeks treatment. Both PMR and GCA patients were affected, the latter more commonly. Isotope scans were abnormal in 7 of 29 patients and remained abnormal on follow-up. The arterial fraction of hepatic flow was significantly reduced in GCA patients in comparison with those having PMR only; values became normal after treatment. These abnormalities may be due to hepatic arteritis.

Key words

Alkaline Phosphatase Isotope Scans Arterial Flow Fraction Follow-up Granulomata 

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References

  1. 1.
    Hall, G.H., Hargreaves, T. Giant cell arteritis and raised serum alkaline phosphatase levels. Lancet 1972, 2, 48.Google Scholar
  2. 2.
    Mowat, A.G., Hazleman, B.L. Polymyalgia rheumatica — a clinical study with particular reference to arterial disease. J Rheumatol 1974, 1, 190–202.PubMedGoogle Scholar
  3. 3.
    Malmvall, B.E., Bengtsson, B.A. GCA. Clinical features and involvement of different organs. Scand J Rheumatol 1978, 7, 154–158.PubMedGoogle Scholar
  4. 4.
    Chuang, T-Y., Hunder, G.G., Ilstrup, D.M., Kurland, L.T. Polymyalgia rheumatica. A 10-year epidemiological and clinical study. Ann Intern Med 1982, 97, 672–680.PubMedGoogle Scholar
  5. 5.
    Wadman, B., Werner, I. Observations on temporal arteritis. Acta Med Scand 1972, 192, 377–383.PubMedGoogle Scholar
  6. 6.
    McCormack, L.R., Astarita, R.W., Foroozan, P. Liver involvement in giant cell arteritis. Am J Diag Dis 1978, 23 (suppl), 72s-74s.Google Scholar
  7. 7.
    Heptinstall, R.H., Porter, K.A., Barkley, H. Giant cell (temporal) arteritis. J Pathol 1954, 57, 507–519.Google Scholar
  8. 8.
    Ogilvie, A.L., James, P.D., Toghill, P.J. Hepatic involvement in polymyalgia arteritica. J Clin Pathol 1981, 34, 769–772.PubMedGoogle Scholar
  9. 9.
    Long, R., James, O. Polymyalgia rheumatica and liver disease. Lancet 1974, 1, 77–79.PubMedGoogle Scholar
  10. 10.
    Kosolcharoen, P., Magnin, G.E. Liver dysfunction and polymyalgia rheumatica. A case report. J Rheumatol 1976, 3, 50–53.PubMedGoogle Scholar
  11. 11.
    Litwack, K.D., Bohan, A., Silverman, L. Granulomatous liver disease and giant cell arteritis. J Rheumatol 1977, 4, 307–312.PubMedGoogle Scholar
  12. 12.
    Fainaru, M., Friedman, G., Friedman, B. Temporal arteritis in israel. A review of 47 patients. J Rheumatol 1979, 6, 330–335.PubMedGoogle Scholar
  13. 13.
    von Knorring, J., Wasatjerna, C. Liver involvement in polymyalgia rheumatica. Scand J Rheumatol 1976, 5, 197–204.PubMedGoogle Scholar
  14. 14.
    Leong, A.S-Y., Alp, M.H. Hepatocellular disease in giant cell arteritis/polymyalgia rheumatica syndrome. Ann Rheum Dis 1981, 40, 92–95.PubMedGoogle Scholar
  15. 15.
    Robertson, J.C., Batstone, G.F., Loebl, W.Y. Polymyalgia rheumatica and primary biliary cirrhosis. Br Med J 1978, 2, 1128.PubMedGoogle Scholar
  16. 16.
    Hamblin, T.J. Significance of antimitochondrial antibodies. Lancet 1981, 2, 1411–1412.Google Scholar
  17. 17.
    Sattar, M.A., Cawley, M.I.D., Hamblin, T.J., Robertson, J.C. Polymyalgia rheumatica and antimitochondrial antibodies. Ann Rheum Dis 1984, 43, 264–266.PubMedGoogle Scholar
  18. 18.
    Jones, J.G., Kyle, M.V., Hazleman, B.L., Wraight, E.P. Abnormal radionuclide liver scans in GCA. Ann Rheum Dis 19, 43, 581–582.Google Scholar
  19. 19.
    Mann, D.C., Toole, J.F. Cranial arteritis with liver involvement. Stroke 1972, 3, 131–134.PubMedGoogle Scholar
  20. 20.
    Ghose, M.K., Shensa, S., Lerler, P.I. Arteritis of the aged (giant cell arteritis) and fever of unexplained origin. Am J Med 1976, 60, 429–436.PubMedGoogle Scholar
  21. 21.
    Jones, J.G., Hazleman, B.L. Prognosis and management of polymyalgia rheumatica. Ann Rheum Dis 1981, 40, 1–5.PubMedGoogle Scholar
  22. 22.
    Wraight, E.P., Barber, R.W., Ritson, A. Relative hepatic arterial and portal flow in liver scintigraphy. Nucl Med Commun 1982, 3, 273–279.Google Scholar
  23. 23.
    Allison, M.C., Gallacher, P.J. Temporal artery biopsy and corticosteroid treatment. Ann Rheum Dis 1984, 43, 416–417.PubMedGoogle Scholar
  24. 24.
    Lockwood, C.M., Bakes, D., Jones, S., Whitaker, K.B., Moss, D.W., Savage, C.O.S. Association of alkaline phosphatase with an autoantibody recognised by circulating anti-neutrophil antibodies in systemic vasculitis. Lancet 1987, 1, 716–720.PubMedGoogle Scholar

Copyright information

© Acta Medica Belgica 1991

Authors and Affiliations

  • V. Kyle
    • 1
  • E. P. Wraight
    • 2
  • B. L. Hazleman
    • 1
  1. 1.Department of Rheumatology ResearchAddenbrooke's HospitalCambridgeUK
  2. 2.Department of Nuclear MedicineAddenbrooke's HospitalCambridgeUK

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