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Giant cell arteritis

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https://www.readbyqxmd.com/read/28440088/head-and-neck-giant-cell-arteritis-an-autoimmune-disease-with-many-faces
#1
Markus Wirth, Lucas Schirmer, Benedikt Hofauer, Magdalena Lenschow, Daria Loos, Klaus Thuermel, Andreas Knopf
CONCLUSION: A high rate of infrequent presentations of giant cell arteritis were seen in the ENT department and should be anticipated as a differential diagnosis in every older patient with odynophagia with high CRP values without cause in thorough ENT examination. OBJECTIVE: To describe the clinical manifestation of head and neck giant cell arteritis and to derive a diagnostic pathway covering atypical cases. METHOD: Single-center, retrospective analysis of cases with GCA in the head and neck region (HN-GCA) (2002-2012) to describe the clinical presentation and to derive a diagnostic pathway covering manifestations presenting to an ENT department...
April 25, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28432167/a-tale-of-two-vasculitides-biopsy-proven-giant-cell-arteritis-followed-by-the-independent-development-of-renal-limited-microscopic-polyangiitis
#2
Roman Zuckerman, Mayur Patel, Deborah R Alpert
We describe an 80-year-old woman who presented with headaches, bilateral jaw claudication and visual symptoms. She was diagnosed with giant cell arteritis, which was confirmed by temporal artery biopsy. She was treated with high-dose prednisone followed by a slow taper, with complete resolution of symptoms. Approximately 4 years later, she developed progressively worsening renal function associated with haematuria. Serological workup revealed a high-titre perinuclear antinuclear cytoplasmic antibody and antibodies to myeloperoxidase...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28431106/ultrasound-cut-off-values-for-intima-media-thickness-of-temporal-facial-and-axillary-arteries-in-giant-cell-arteritis
#3
Valentin S Schäfer, Aaron Juche, Sofia Ramiro, Andreas Krause, Wolfgang A Schmidt
Objective.: To evaluate the intima-media thickness (IMT) of arteries involved in GCA for determining cut-off values. Methods.: Forty newly diagnosed GCA patients in a fast-track GCA clinic and 40 age- and sex-matched controls were included. IMT measurement was performed at or within 24 h after diagnosis. The common superficial temporal arteries with their frontal and parietal branches and the facial arteries were bilaterally examined with a 10-22 MHz probe and the axillary artery with a 6-18 MHz probe...
April 20, 2017: Rheumatology
https://www.readbyqxmd.com/read/28424735/tongue-necrosis-secondary-to-giant-cell-arteritis-a-case-report-and-literature-review
#4
Rafael Alex Barbosa de Siqueira Sobrinho, Karolina Cayres Alvino de Lima, Helena Carvalho Moura, Mônica Modesto Araújo, Christyanne Maria Rodrigues Barreto de Assis, Pedro Alves da Cruz Gouveia
Giant cell arteritis is a form of vasculitis involving the medium- and large-sized arteries that chiefly affects older people. Clinical findings are headache, jaw claudication, fever, pain, and thickening of the temporal artery. The most feared complication is visual loss due to impairment of the ophthalmic artery and posterior ciliary arteries. This a case report of an 85-year-old male presenting with headache and jaw pain, who was admitted with tongue necrosis as an initial manifestation of giant cell arteritis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28418359/-a-rare-concurrence-of-polymyalgia-rheumatica-and-aa-amyloidosis
#5
S G Radenska-Lopovok, O N Kotenko, N F Frolova, A I Zagrebneva, E S Stolyarevich, E V Volodina, V I Chervinko, E V Kryukov, M L Zubkin
Polymyalgia rheumatica (PMR) is a rare chronic inflammatory disease. It predominantly affects the elderly. The disease has a slow onset, pain and stiffness in the muscles of the shoulder and pelvic girdle, fever, weight loss, and a high acute-phase inflammatory response. The disease is concurrent with giant cell arteritis in a quarter of cases, which allows some authors to consider them as two different manifestations of the same pathological process. The kidneys are rarely involved. This disease is rarely complicated by AA amyloidosis...
2017: Arkhiv Patologii
https://www.readbyqxmd.com/read/28405843/quality-of-life-of-patients-treated-for-giant-cell-arteritis-a-case-control-study
#6
Stéphanie Jobard, Julie Magnant, Hélène Blasco, Nicole Ferreira-Maldent, Isabelle Griffoul, Elisabeth Diot, François Maillot
The objective of the study was to assess the quality of life (QOL) of patients with giant cell arteritis (GCA), following high dose of corticosteroids (CS). Thirty patients with GCA who had stopped CS or who were under long-term low dose of CS were included and matched to 60 controls. QOL was measured by the SF-36 score and a specific questionnaire. GCA patients had no impairment of QOL compared to controls according to SF-36. Most of them (57%) estimated that their general condition was improved following treatment...
April 12, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28405470/is-vascular-endothelial-growth-factor-a-useful-biomarker-in-giant-cell-arteritis
#7
Nicola Goodfellow, Julien Morlet, Surjeet Singh, Afsie Sabokbar, Andrew Hutchings, Vanshika Sharma, Jana Vaskova, Shauna Masters, Allahdad Zarei, Raashid Luqmani
OBJECTIVES: To assess the performance of circulating vascular endothelial growth factor (VEGF) levels as a tool for diagnosing giant cell arteritis (GCA) in a cohort of patients referred for assessment of suspected GCA. METHODS: We selected 298 patients recruited to the multicentre study Temporal Artery Biopsy versus Ultrasound in diagnosis of suspected GCA (TABUL). In a random subset of 26 biopsy-proven GCA cases and 26 controls, serum from weeks 0, 2 and 26 was analysed for VEGF concentration using ELISA...
2017: RMD Open
https://www.readbyqxmd.com/read/28394967/-extensive-arterial-involvement-in-giant-cell-arteritis-report-of-one-case
#8
Daniela Grünholz, María Paz Poblete, Loreto Ovalle, Eduardo Wainstein, Gloria Rubio, María Manríquez, Karin Kalbhenn
Large vessel vasculitis and particularly Temporal Arteritis are systemic diseases that may affect the aorta and its major branches, mainly involving extra cranial branches of the carotid artery. We report a 72-year-old man presenting with weight loss, fever and malaise. Positron emission computed tomography (PET CT) showed an extensive inflammation of the aorta and its major branches. Temporal artery biopsy confirmed the presence of vasculitis with granulomas. Treatment with a high dose of steroids had an excellent clinical response...
November 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28375835/b-mode-sonography-wall-thickness-assessment-of-the-temporal-and-axillary-arteries-for-the-diagnosis-of-giant-cell-arteritis-a-cohort-study
#9
Michael Czihal, Angelika Schröttle, Kerstin Baustel, Christian Lottspeich, Claudia Dechant, Karla-Maria Treitl, Marcus Treitl, Hendrik Schulze-Koops, Ulrich Hoffmann
OBJECTIVES: We aimed to determine the diagnostic accuracy of B-mode compression sonography of the temporal arteries (tempCS) and B-mode sonographic measurement of the axillary artery intima media thickness (axIMT) for the diagnosis of giant cell arteritis (GCA). METHODS: After having established measurement of tempCS and axIMT in our routine diagnostic workup, 92 consecutive patients with a suspected diagnosis of GCA were investigated. Clinical characteristics were recorded and wall thickening of the temporal arteries (tempCS) and axillary arteries (axIMT) was measured (mm)...
April 4, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28375834/the-role-of-ultrasound-in-the-diagnosis-and-follow-up-of-large-vessel-vasculitis-an-update
#10
Giuseppe Germanò, Sara Monti, Cristina Ponte, Niccolo' Possemato, Roberto Caporali, Carlo Salvarani, Pierluigi Macchioni, Nicolò Pipitone
Large-vessel vasculitides comprise giant cell arteritis and Takayasu's arteritis. In both conditions, early changes consist of transmural inflammation of the arterial wall, while later complications include lumen changes, such as stenoses or aneurysms. Colour-Doppler sonography has the ability to depict the arterial wall as well as the lumen, and is therefore ideally suited both to diagnose early vasculitis and to monitor patients over time. In this review article, we addressed the following issues: 1) the role of colour-Doppler sonography in the diagnosis of large-vessel vasculitis and its common pitfalls; 2) whether colour-Doppler sonography can increase the yield of temporal artery biopsy in giant cell arteritis; 3) the role of colour-Doppler sonography in monitoring patients with LVV over time; and 4) how colour-Doppler sonography performs compared to other imaging techniques...
March 29, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28367219/alpha-1-antitrypsin-deficiency-presenting-with-mpo-anca-associated-vasculitis-and-aortic-dissection
#11
Bram M Voorzaat, Jan van Schaik, Stijn L P Crobach, Catharina S P van Rijswijk, Joris I Rotmans
The combination of alpha-1 antitrypsin (AAT) deficiency, ANCA-vasculitis, and aortic aneurysm has been rarely described in literature. We report an eventually fatal case in a 70-year-old patient who initially presented with giant cell arteritis and ANCA associated glomerulonephritis. Several years later, he presented with aortic dissection due to large vessel vasculitis, raising the suspicion of AAT deficiency, as two first-line relatives had chronic obstructive pulmonary disease, while they never smoked. This diagnosis was confirmed by AAT electrophoresis and immunohistochemistry on a temporal artery biopsy...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28352206/color-duplex-ultrasonography-findings-of-temporal-arteries-in-a-case-of-giant-cell-arteritis-role-in-diagnosis-and-follow-up
#12
Antonella Laria, Alfredo Lurati, Magda Scarpellini
Giant cell arteritis (GCA) is a systemic autoimmune disease that affects medium- and large-sized arteries. The diagnostic gold standard is the temporal artery biopsy, but it has limited sensitivity and some difficulties in reproducibility. Color duplex ultrasonography is a noninvasive, reproducible, and inexpensive method for diagnosis of temporal arteries involvement (temporal arteritis [TA]) in GCA with high sensitivity and specificity. We present the ultrasound findings at baseline and during follow-up in a case of TA in a patient with GCA...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28339362/diagnostic-performance-of-color-duplex-ultrasonography-along-with-temporal-artery-biopsy-in-suspicion-of-giant-cell-arteritis
#13
Christophe Roncato, Caroline Allix-Béguec, Elisabeth Brottier-Mancini, Bruno Gombert, Guillaume Denis
OBJECTIVES: Giant cell arteritis (GCA) is a vasculitis that occurs in older adults, affecting vessels of medium and large caliber. GCA diagnosis is a challenge for general practitioners and specialists. The aim of this study was to retrospectively analyse performances of temporal artery biopsy (TAB) and color duplex ultrasonography (CDU) for GCA diagnosis. METHODS: All patients with suspicion of GCA and who underwent both TAB and CDU between April 2009 and March 2014 were included in the study...
March 20, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28339357/development-of-a-score-for-assessment-of-radiologic-damage-in-large-vessel-vasculitis-combined-arteritis-damage-score-cards
#14
Daiki Nakagomi, Claire Cousins, Jan Sznajd, Shunsuke Furuta, Aladdin J Mohammad, Raashid Luqmani, David Jayne
OBJECTIVES: Outcome assessment in large-vessel vasculitis (LVV) remains challenging and this impairs patient management and the conduct of clinical studies. Previous proposals for outcome tools have not included imaging. This study aimed to develop an imaging score to quantify damage in LVV and to assess the difference between Takayasu (TAK) and giant cell arteritis (GCA). METHODS: Ninety-six patients (41 TAK, 55 GCA) were identified from local registries at two University Hospitals in the UK...
March 13, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28335992/varicella-zoster-virus-vasculopathy-the-expanding-clinical-spectrum-and-pathogenesis
#15
REVIEW
Maria A Nagel, Dallas Jones, Ann Wyborny
Varicella zoster virus (VZV) is a ubiquitous, human alphaherpesvirus that produces varicella on primary infection then becomes latent in ganglionic neurons along the entire neuraxis. In elderly and immunocompromised individuals, VZV reactivates and travels along nerve fibers peripherally resulting in zoster. However, VZV can also spread centrally and infect cerebral and extracranial arteries (VZV vasculopathy) to produce transient ischemic attacks, stroke, aneurysm, sinus thrombosis and giant cell arteritis, as well as granulomatous aortitis...
March 18, 2017: Journal of Neuroimmunology
https://www.readbyqxmd.com/read/28332442/ultrasound-imaging-in-the-diagnosis-of-large-vessel-vasculitis
#16
Michael Czihal, Christian Lottspeich, Ulrich Hoffmann
Nowadays noninvasive vascular imaging has an important role in the diagnostic work-up of the large vessel vasculitides (LVV), most importantly giant cell arteritis (GCA) and Takayasu arteritis. Among the imaging modalities available, ultrasound (US) has several important advantages, including low costs, rapid and repetitive availability without exposure to radiation, and high spatial resolution for assessment of large and medium-sized arteries. Therefore, US can be regarded the first line imaging method in suspected LVV...
March 23, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28323232/suspected-giant-cell-aortitis-from-multiple-aortic-structural-damage-to-fatal-listeria-sepsis-a-case-report
#17
Valeria Silvestri, Giacomo Isernia
Giant cell arteritis (GCA) is an inflammatory vasculopathy affecting large- and middle-sized vessels, specifically cranial arteries derived from carotid artery. Isolated extracranial vessel involvement can occur. Interest in extravascular manifestations is recently increasing because of diffusion of sensitive and specific imaging tools such as fluorodeoxyglucose positron emission tomography computerized tomography (18 FDG PET CT). Patients have an increased relative risk of severe infection. Listeria monocytogenes infection risk is increased, and vascular system involvement and graft infection have been, although rarely, reported...
March 18, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28320119/giant-cell-arteritis-following-varicella-zoster-vaccination
#18
Itay Lotan, Israel Steiner
BACKGROUND: Giant cell arteritis (GCA) is a form of large-vessel vasculitis affecting patients older than 50years old. Recent reports have suggested that the condition is caused by reactivation of varicella zoster virus (VZV). If that is indeed the case, a vaccine that prevents VZV reactivation should reduce the incidence of GCA. To further test that hypothesis, we assessed the incidence of GCA among patients older than 50years of age who were vaccinated against VZV and compared it to GCA incidence in the general population...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28315516/metaplastic-ossification-of-the-temporal-artery-with-osteoclast-like-giant-cells-a-mimicker-of-giant-cell-temporal-arteritis
#19
Miroslav Sekulic, Alexander M Truskinovsky
PURPOSE: To describe a patient presenting with suspected giant cell (temporal) arteritis (GCA) in whom subsequent temporal artery biopsy showed luminal narrowing by medial calcification, metaplastic ossification, and fibrointimal proliferation, consistent with calciphylaxis. METHODS: A 55-year-old man with end-stage renal disease presented with unilateral loss of vision and elevated erythrocyte sedimentation rate and was initially treated as though he had GCA; however, a subsequent temporal artery biopsy showed marked luminal narrowing by medial calcification, metaplastic ossification, and fibrointimal proliferation, consistent with calciphylaxis...
February 28, 2017: European Journal of Ophthalmology
https://www.readbyqxmd.com/read/28314758/immune-checkpoint-dysfunction-in-medium-and-large-vessel-vasculitis
#20
Ryu Watanabe, Hui Zhang, Gerald Berry, Jorg J Goronzy, Cornelia M Weyand
Giant cell arteritis (GCA) is a granulomatous vasculitis of the aorta and its medium-sized branch vessels. CD4 T-cells, macrophages and dendritic cells build granulomatous infiltrates that injure the vessel wall and elicit a maladaptive response-to-injury. Pathologic consequences include fragmentation of elastic membranes, destruction of the medial layer, microvascular neoangiogenesis, massive outgrowth of myofibroblasts, and lumen-occlusive intimal hyperplasia. Antigens have been suspected to drive the local activation of vasculitogenic CD4 T-cells, but recent data suggest a more generalized defect in the threshold setting of such T-cells, rendering them hyperreactive...
March 17, 2017: American Journal of Physiology. Heart and Circulatory Physiology
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