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Large vessel vasculitis

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https://www.readbyqxmd.com/read/28803683/immune-response-in-takayasu-arteritis
#1
Tristan Mirault, Henri Guillet, Emmanuel Messas
Takayasu arteritis (TAK) is a vasculitis of the large arteries. The arterial wall, target of the immune reaction, is composed of vascular dendritic cells, endothelial cells, vascular smooth muscle cells and fibroblasts, which engage in an interaction with T cells and macrophages to, ultimately, cause luminal stenosis or aneurysmal wall damage of the vessel. A multitude of cytokines have been identified to increase in case of TAK and to be linked to disease activity. A better understanding of the physiopathological pathways and mechanisms involved, might enable a more tailored therapeutic approach in TAK...
August 10, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28800947/-from-pathogenesis-of-giant-cell-arteritis-to-new-therapeutic-targets
#2
M Samson, B Bonnotte
Giant cell arteritis (GCA) is the most common vasculitis in adults. GCA is a granulomatous large-vessel vasculitis involving the aorta and its major branches in people>50 years. Glucocorticoids (GC) remain the cornerstone of GCA treatment. Prednisone is usually started at 0.7 or 1mg/kg/day depending on the occurrence of ischemic complications. Then, GC are progressively tapered and stopped after a mean duration of 18 months. GC are very efficient but relapses often occur during their tapering. Moreover, GC-related side effects are very common during this long term GC therapy...
August 8, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28799318/giant-cell-arteritis-presenting-as-puo
#3
Sham Santhanam, Sampath Kumar Mani
Giant cell arteritis(GCA) is a primary granulomatous vasculitis affecting the large and medium sized arteries. We present here a case of GCA with pyrexia of unknown origin (PUO) as the presenting manifestation in the absence of other typical features. On evaluation, the patient had raised inflammatory markers with features of large vessel vasculitis on whole body PET-CT scan. The colour doppler ultrasonography(CDUS) of the temporal arteries showed bilateral halo sign. Since bilateral 'halo sign' is more specific for the diagnosis of GCA, temporal artery biopsy is not mandatory...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28774474/classification-of-large-vessel-vasculitis-can-we-separate-giant-cell-arteritis-from-takayasu-arteritis
#4
Matthew J Koster, Kenneth J Warrington
The two main variants of large vessel vasculitis include Takayasu arteritis and giant cell arteritis. While these two conditions have historically been considered different conditions, recent evidence questions whether they are a spectrum of the same disease. Classification criteria are limited in distinguishing between cases with phenotypic overlap. The limitations of the current criteria and directions of future research are reviewed.
July 31, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28774453/imaging-of-childhood-vasculitis
#5
REVIEW
Claudio Granata, Maria Beatrice Damasio, Federico Zaottini, Sonia Airaldi, Clara Malattia, Giovanna Stefania Colafati, Paolo Tomà, Gianmichele Magnano, Carlo Martinoli
Pediatric vasculitides are rare conditions that can represent a diagnostic challenge because symptoms are usually aspecific and variable. Symptoms are related to the size of the involved vessel, extension of disease, and organs affected. The outcome is closely linked to an early diagnosis and proper treatment. Diagnostic imaging allows visualization of the involvement of large-size and medium-size vessels and assesses end-organ changes and response to therapy, thus playing a pivotal role in the diagnosis and treatment...
September 2017: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/28765420/lesson-of-the-month-1-large-vessel-vasculitis-a-diagnostic-challenge-and-the-role-of-18-fluorodeoxyglucose-positron-emission-tomography
#6
Andrew Allard, Ramesh Mootoo
Large vessel vasculitis can pose a significant diagnostic challenge. It may be insidious in onset with the only presenting symptoms consisting of constitutional compromise. It may mimic other pathologies and the only serological abnormalities may be abnormal inflammatory markers. Conventional imaging modalities may not be diagnostic. We present a case of large vessel vasculitis that proved a significant diagnostic challenge with diagnosis established on 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) computerised tomography (CT) imaging...
July 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28758156/varicella-zoster-virus-and-large-vessel-vasculitis-the-absence-of-an-association
#7
Gary W Procop, Charis Eng, Alison Clifford, Alexandra Villa-Forte, Leonard H Calabrese, Eric Roselli, Lars Svensson, Douglas Johnston, Gosta Pettersson, Edward Soltesz, Lisa Lystad, Julian D Perry, Alexander Blandford, Deborah A Wilson, Gary S Hoffman
OBJECTIVE: It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen...
2017: Pathogens & Immunity
https://www.readbyqxmd.com/read/28756072/epidemiology-of-takayasu-arteritis
#8
Fatos Onen, Nurullah Akkoc
Takayasu arteritis (TA), a granulomatous large vessel vasculitis involves mostly the aorta and its proximal branches and occurs most commonly in young females. The data on the epidemiology of TA is limited, probably due to the rarity of the disease. Although the disease has a worldwide distribution, it is generally thought to be much more common among Asian populations. The incidences of TA were estimated to be 1-2 per million in Japan and 2.2 per million in Kuwait. Recent epidemiologic studies suggest that TA is being increasingly recognized in Europe with reported incidence estimates varying from 0...
July 26, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28748225/abnormal-molecular-response-to-takayasu-arteritis-causing-extensive-large-vessel-calcification
#9
Brandon T Garland, Manfred Boehm, Peter C Grayson, Cynthia St Hilaire, Alessandra Brofferio, Benjamin W Starnes
Takayasu arteritis is a large-vessel vasculitis that often results in pulselessness due to fibrotic stenoses. Whereas minor calcification is sometimes seen with Takayasu arteritis, it rarely causes stenosis. Extensive calcification resulting in malperfusion is exceedingly rare and has been attributed to disorders in calcium trafficking in a chronic inflammatory state. We report an unusual case of rapidly progressive and extensive aortic calcification in the setting of Takayasu arteritis.
December 2016: J Vasc Surg Cases Innov Tech
https://www.readbyqxmd.com/read/28743241/complete-ophthalmoplegia-complete-ptosis-and-dilated-pupil-due-to-internal-carotid-artery-dissection-as-the-first-manifestation-of-takayasu-arteritis
#10
H M M T B Herath, S P Pahalagamage, D Withana, Sunethra Senanayake
BACKGROUND: Takayasu arteritis is a rare, chronic large vessel vasculitis involving the aorta and its primary branches. As the disease progresses, the active inflammation of large vessels leads to dilation, narrowing and occlusion of the arteries. Arterial dissection is due to separation of the layers of the arterial wall resulting in a false lumen, where blood seeps into the vessel wall. Neurological sequelae of intracranial arterial dissection results from cerebral ischemia due to thromboembolism and hypo perfusion...
July 25, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28733791/current-clinical-evidence-of-tocilizumab-for-the-treatment-of-anca-associated-vasculitis-a-prospective-case-series-for-microscopic-polyangiitis-in-a-combination-with-corticosteroids-and-literature-review
#11
REVIEW
Ryota Sakai, Tsuneo Kondo, Takahiko Kurasawa, Eiko Nishi, Ayumi Okuyama, Kentaro Chino, Akiko Shibata, Yusuke Okada, Hirofumi Takei, Hayato Nagasawa, Koichi Amano
The purpose of this study is to report the efficacy and safety of a combination of tocilizumab (TCZ) and high-dose corticosteroid (CS) in two patients with microscopic polyangiitis (MPA) and review the published current clinical evidence on TCZ in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), except for large vessel vasculitis (LVV) and polymyalgia rheumatica (PMR). Two MPA patients were treated with TCZ at 8 mg/kg every month for 1 year and CS (prednisolone 1 mg/kg/day for 2 weeks, followed by tapering) in a prospective single-arm, single-center, cohort, open-label pilot study (UMIN clinical trials: 000012072)...
July 21, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28728567/settings-and-artefacts-relevant-for-doppler-ultrasound-in-large-vessel-vasculitis
#12
REVIEW
L Terslev, A P Diamantopoulos, U Møller Døhn, W A Schmidt, S Torp-Pedersen
Ultrasound is used increasingly for diagnosing large vessel vasculitis (LVV). The application of Doppler in LVV is very different from in arthritic conditions. This paper aims to explain the most important Doppler parameters, including spectral Doppler, and how the settings differ from those used in arthritic conditions and provide recommendations for optimal adjustments. This is addressed through relevant Doppler physics, focusing, for example, on the Doppler shift equation and how angle correction ensures correctly displayed blood velocity...
July 20, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28724574/the-microvascular-niche-instructs-t-cells-in-large-vessel-vasculitis-via-the-vegf-jagged1-notch-pathway
#13
Zhenke Wen, Yi Shen, Gerald Berry, Farhad Shahram, Yinyin Li, Ryu Watanabe, Yaping Joyce Liao, Jörg J Goronzy, Cornelia M Weyand
Microvascular networks in the adventitia of large arteries control access of inflammatory cells to the inner wall layers (media and intima) and thus protect the immune privilege of the aorta and its major branches. In autoimmune vasculitis giant cell arteritis (GCA), CD4 T helper 1 (TH1) and TH17 cells invade into the wall of the aorta and large elastic arteries to form tissue-destructive granulomas. Whether the disease microenvironment provides instructive cues for vasculitogenic T cells is unknown. We report that adventitial microvascular endothelial cells (mvECs) perform immunoregulatory functions by up-regulating the expression of the Notch ligand Jagged1...
July 19, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28722366/-large-vessel-vasculitis-pathogenesis-diagnostic-and-medical-management
#14
Alireza Sadrkhah, Jörg D Seebach, Yannick Muller
Large vessels vasculitis includes two diseases : 1) giant cell arteritis, formerly known as Horton's arteritis and 2) Takayasu arteritis. In this article, we will describe and compare the epidemiology, pathogenesis, diagnostic criteria and medical management of both vasculitis. T helper (Th) 1 and Th17 responses, genetic links and the role of viral (varicella zoster) and bacterial infection (Mycoplasma pneumoniae or Chlamydia pneumoniae) will be discussed. Classification criteria, inflammation biomarkers and progress in imaging tools will also be described...
April 5, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28712642/a-rare-case-of-febrile-abdominal-pain-revealing-horton-s-disease
#15
Arnaud Chaudet, Jean-Michel Goujon, Aiham Daniel Ghazali
BACKGROUND: Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. CASE PRESENTATION: A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome...
July 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28709561/factors-associated-with-need-for-revascularisation-in-non-coronary-arterial-occlusive-lesions-secondary-to-takayasu-s-arteritis
#16
C A Hinojosa, J E Anaya-Ayala, Z Gomez-Arcive, H Laparra-Escareno, A Torres-Machorro, R Lizola
OBJECTIVE/BACKGROUND: Takayasu's arteritis (TA) is rare inflammatory large vessel form of vasculitis. The objective of this study was to evaluate experience in the management of TA patients and to identify the influence of inflammatory markers and clinical variables associated with disease progression, worsening ischaemic symptoms, and the need for interventions. METHODS: Demographics, and laboratory and clinical variables in patients that required revascularisation procedures were compared with those who had adequate symptomatic control with medical management...
July 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28696270/looking-for-the-right-side-in-large-vessel-vasculitis-a-multimodality-imaging-guided-success
#17
Ana Rita Ramalho, Susana Costa, João Silva Marques
No abstract text is available yet for this article.
July 11, 2017: Circulation
https://www.readbyqxmd.com/read/28684264/leg-pain-from-periostitis-as-the-first-clinical-manifestation-of-large-vessel-vasculitis-a-case-report
#18
Bert Bogaert, Peter Brys, Koen Peers
We report a case of a 47-year-old woman with isolated periostitis of the lower leg as a first manifestation of large-vessel vasculitis. The diagnosis was first suspected when a second magnetic resonance imaging of the lower leg approximately 4 months after onset of shin pain showed edema near intramuscular vessels. Isolated periostitis is a very rare skeletal manifestation of systemic vasculitis and easily could be misdiagnosed. This case demonstrates that maintaining a broad differential diagnosis for a common presenting complaint such as localized leg pain is imperative...
July 3, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28673107/annuloplasty-for-aortic-regurgitation-in-infantile-takayasu-arteritis-a-case-report
#19
Laura Linnemeier, Richa Sharma, Nayan Srivastava, Mark Turrentine
Aortic regurgitation (AR) is a life-threatening complication of Takayasu arteritis (TA). Takayasu arteritis is a large-vessel vasculitis with a predominance in young adolescent and adult females. Inflammation involves the aorta and its major branches resulting in arterial dilatation, stenosis, aneurysm, occlusion, and thrombosis formation. Pediatric TA cases have been reported to also cause severe complications such as coronary aneurysms, retinopathy, and hypertension due to renovascular stenosis. In this report, we present a rare occurrence of infantile TA with severe AR requiring surgical intervention after failing medical therapy...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28664283/-positron-emission-tomography-computed-tomography-in-rheumatology
#20
T Derlin
Combined positron emission tomography/computed tomography (PET/CT) is a whole-body imaging procedure, which enables sensitive detection of inflammatory changes. It may be used to simultaneously obtain both precise anatomical and molecular information in order to comprehensively characterize diseases. The glucose analogue (18)F-fluorodeoxyglucose (FDG) represents a universally applicable radiotracer for imaging of inflammatory processes. Its accumulation in tissues can be semiquantitatively characterized by use of standardized uptake values (SUV)...
June 29, 2017: Zeitschrift Für Rheumatologie
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