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Large vessel vasculitis

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https://www.readbyqxmd.com/read/28899801/is-pet-ct-essential-in-the-diagnosis-and-follow-up-of-temporal-arteritis
#1
REVIEW
Carlo Salvarani, Alessandra Soriano, Francesco Muratore, Yehuda Shoenfeld, Daniel Blockmans
The increasing availability and improvement of imaging techniques are deeply influencing diagnosis and work-up of patients affected with vasculitis, particularly those with large vessel vasculitis (LVV). Fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET), especially when integrated with computed tomography (CT), is taking hold as a useful diagnostic technique to examine the aorta and the other large vessels in giant cell arteritis (GCA) with concomitant large vessel involvement (LV-GCA). In this paper we examined the progresses performed in this field in the last twenty years and the evidence available so far according to two different points of view ('pros' and 'cons'), in order to give a comprehensive answer to a still open question about the role of PET/CT in the diagnosis and follow-up of GCA...
September 9, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28895653/clinical-interventions-for-takayasu-arteritis-a-systematic-review
#2
REVIEW
Rafael L Pacheco, Carolina de Oliveira Cruz Latorraca, Alexandre Wagner Silva de Souza, Daniela V Pachito, Rachel Riera
INTRODUCTION: Takayasu arteritis (TA) is a rare systemic vasculitis that affects large vessels often resistant to treatment and associated with high morbidity and mortality. Treatment is defied by the relapsing nature of the disease and frequent adverse effects of corticosteroids and immunosuppressors, rendering failure of treatment in a significant portion of patients. Considering the low quantity and quality of published studies focusing on treatment of TA, synthesis and critical assessment of the available evidence is fundamental to establish recommendations for clinical practice...
September 12, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28895041/unmet-needs-in-the-pathogenesis-and-treatment-of-vasculitides
#3
REVIEW
Francesco Muratore, Giulia Pazzola, Alessandra Soriano, Nicolò Pipitone, Stefania Croci, Martina Bonacini, Luigi Boiardi, Carlo Salvarani
Despite the progress in the last years on the field of vasculitides, there are several unmet needs regarding classification, disease activity assessment, predictors of flares and complications, and type of treatment for the different forms. The 1990 American College of Rheumatology (ACR) classification criteria currently used to define giant cell arteritis and Takayasu arteritis were designed to discriminate between different types of vasculitides but not to differentiate vasculitis from other disorders. Recently, efforts have been made to overcome the shortcomings of the ACR criteria...
September 11, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28864648/assessment-of-disease-activity-in-large-vessel-vasculitis-results-of-an-international-delphi-exercise
#4
Sibel Z Aydin, Haner Direskeneli, Peter A Merkel
OBJECTIVE: To arrive at consensus for candidate outcomes for disease activity assessment in large-vessel vasculitis (LVV) in clinical trials. METHODS: A Delphi survey including 99 items was circulated among international experts for 3 rounds. RESULTS: Fifty-seven items were accepted for both giant cell arteritis and Takayasu arteritis. Sixty-seven percent of experts voted to have a common approach for both diseases with additional disease-specific items such as weight loss, scalp tenderness/necrosis, morning stiffness, dizziness, visual symptoms, and imaging...
September 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28864646/development-of-a-core-set-of-outcome-measures-for-large-vessel-vasculitis-report-from-omeract-2016
#5
Antoine G Sreih, Fatma Alibaz-Oner, Tanaz A Kermani, Sibel Z Aydin, Peter F Cronholm, Trocon Davis, Ebony Easley, Ahmet Gul, Alfred Mahr, Carol A McAlear, Nataliya Milman, Joanna C Robson, Gunnar Tomasson, Haner Direskeneli, Peter A Merkel
OBJECTIVE: Among the challenges in conducting clinical trials in large-vessel vasculitis (LVV), including both giant cell arteritis (GCA) and Takayasu arteritis (TA), is the lack of standardized and meaningful outcome measures. The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group initiated an international effort to develop and validate data-driven outcome tools for clinical investigation in LVV. METHODS: An international Delphi exercise was completed to gather opinions from clinical experts on LVV-related domains considered important to measure in trials...
September 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28844053/non-invasive-method-of-monitoring-retinal-vasculitis-in-patients-with-birdshot-chorioretinopathy-using-optical-coherence-tomography
#6
Jared E Knickelbein, William Tucker, Shilpa Kodati, Marib Akanda, H Nida Sen
BACKGROUND/AIMS: To investigate the utility of using montaged optical coherence tomography (OCT) thickness maps to monitor perivascular thickness as a marker of vasculitic activity in patients with large-vessel retinal vasculitis. METHODS: This is a retrospective cohort study of 22 eyes of 11 patients with a history of retinal vasculitis associated with birdshot chorioretinopathy (BCR). Patients had serial spectral domain 6×6 mm cube OCT scans centred on the fovea, optic nerve and proximal branches of the superior and inferior retinal vessels...
August 26, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28836099/cutaneous-manifestations-of-small-vessel-leukocytoclastic-vasculitides-in-childhood
#7
REVIEW
Sebastiano A G Lava, Gregorio P Milani, Emilio F Fossali, Giacomo D Simonetti, Carlo Agostoni, Mario G Bianchetti
In childhood, cutaneous small-vessel vasculitides include Henoch-Schönlein syndrome, a systemic vasculitis, and Finkelstein-Seidlmayer syndrome, a skin-limited vasculitis. Both Henoch-Schönlein and Finkelstein-Seidlmayer syndromes are seen more frequently in white or Asian compared with black children and occur especially in winter and spring with a male-to-female ratio of approximately 2:1. In everyday clinical practice, both conditions are diagnosed on clinical grounds without histological confirmation...
August 24, 2017: Clinical Reviews in Allergy & Immunology
https://www.readbyqxmd.com/read/28803683/immune-response-in-takayasu-arteritis
#8
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...
July 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28800947/-from-pathogenesis-of-giant-cell-arteritis-to-new-therapeutic-targets
#9
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
#10
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
#11
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 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28774453/imaging-of-childhood-vasculitis
#12
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
#13
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
#14
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
#15
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 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28748225/abnormal-molecular-response-to-takayasu-arteritis-causing-extensive-large-vessel-calcification
#16
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
#17
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
#18
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
#19
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
#20
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
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