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Giant cell arteritis

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https://www.readbyqxmd.com/read/29431135/challenges-of-diagnosis-and-management-of-giant-cell-arteritis-in-general-practice-a-multimethods-study
#1
Toby Helliwell, Sara Muller, Samantha L Hider, James A Prior, Jane C Richardson, Christian D Mallen
BACKGROUND: In the UK, general practitioners (GPs) are usually the first medical contact for patients with suspected giant cell arteritis (GCA). While rare, it is critical not to miss, as delayed treatment can lead to significant complications including permanent visual loss. To date, little is known about the approach and challenges to diagnosis and management of GCA by GPs. OBJECTIVE: To investigate the diagnosis and management of patients with suspected GCA in UK general practice...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29427822/large-vessel-involvement-and-aortic-dilation-in-giant-cell-arteritis-a-multicenter-study-of-549-patients
#2
REVIEW
Hubert de Boysson, Aurélie Daumas, Mathieu Vautier, Jean-Jacques Parienti, Eric Liozon, Marc Lambert, Maxime Samson, Mikael Ebba, Anael Dumont, Audrey Sultan, Bernard Bonnotte, Alain Manrique, Boris Bienvenu, David Saadoun, Achille Aouba
OBJECTIVES: Large-vessel involvement (LVI) can occur in giant-cell arteritis (GCA) and may represent a distinct disease subgroup with a higher risk for aortic dilation. This study aimed to better characterize the presentation and evolution of LVI in patients with GCA. PATIENTS AND METHODS: A retrospective multicenter study enrolled 248 GCA patients with LVI and 301 GCA patients without LVI on imaging. Factors associated with aortic dilation were identified in a multivariable model...
February 7, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/29426788/approach-to-a-patient-with-diplopia-in-the-emergency-department
#3
Edward Margolin, Cindy T Y Lam
BACKGROUND: Diplopia can be the result of benign or life-threatening etiologies. It is imperative for the emergency physician to be proficient at assessing diplopia and recognize when urgent referral or neuroimaging is required. OBJECTIVE: The first part of this review highlights a simple framework to arrive at the appropriate disposition of diplopic patients presenting to the emergency department (ED). The second part of this review provides more detail and further management strategies...
February 6, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29426439/characterization-of-serological-markers-of-healed-healing-arteritis-and-giant-cell-arteritis
#4
Vinay Kansal, Sangsu Han, James Farmer, Danah Albreiki
OBJECTIVE: Temporal artery biopsy (TAB) is the gold standard for confirming the diagnosis of giant cell arteritis (GCA) when positive. However, the clinical significance of healed/healing (HH) arterial injury on TAB is not well understood. The purpose of this study was to evaluate the clinical significance of this finding on TAB by determining its association with seromarkers typically predictive of GCA. DESIGN: Single-centre, retrospective, investigational cohort study...
February 2018: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/29416384/profile-of-tocilizumab-and-its-potential-in-the-treatment-of-giant-cell-arteritis
#5
REVIEW
Susan Patricia Mollan, John Horsburgh, Bhaskar Dasgupta
Giant cell arteritis (GCA) remains a medical emergency due to the threat of permanent sight loss. High-dose glucocorticoids (GCs) are effective in inducing remission in the majority of patients, however, relapses are common which lengthen GC therapy. GC toxicity remains a major morbidity in this group of patients, and conventional steroid-sparing therapies have not yet shown enough of a clinical benefit to change the standard of care. As the understanding of the underlying immunopathophysiology of GCA has increased, positive clinical observations have been made with the use of IL-6 receptor inhibitor therapies, such as tocilizumab (TCZ)...
2018: Eye and Brain
https://www.readbyqxmd.com/read/29414433/il-6-expression-is-correlated-with-increased-t-cell-proliferation-and-survival-in-the-arterial-wall-in-giant-cell-arteritis
#6
Sukhbir Manku, Wendy Wong, Zongshu Luo, Michael A Seidman, Zainab Alabdurubalnabi, Kevin Rey, Winnie Enns, J Antonio Avina-Zubieta, Kamran Shojania, Jonathan C Choy
Giant cell arteritis (GCA) is the most common vasculitis in adults affecting large and medium-sized arteries. IL-6 and T cell accumulation within the arterial wall contribute to the pathogenesis of GCA, and blockade of IL-6 activity is efficacious in its treatment. We examined the relationship between levels of IL-6 expression and immunological processes that control the expansion of T cells in GCA-positive temporal artery biopsies. CD4 T cells accumulated in clusters within the media and deep intima of all GCA lesions...
January 9, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/29409137/mortality-in-patients-with-giant-cell-arteritis-a-cohort-study-in-uk-primary-care
#7
Lin Li, Tuhina Neogi, Susan Jick
OBJECTIVE: To examine whether giant cell arteritis (GCA) is associated with increased all-cause mortality and whether mortality differs according to age, sex, and calendar year of cohort entry. METHODS: Using the UK-based Clinical Practice Research Datalink we identified 9778 newly diagnosed GCA patients from 1990-2014, and up to 10 non-vasculitis patients randomly matched to each case on age, sex, practice and years of history before cohort entry. We used Cox regression to estimate adjusted hazard ratios (HRs) for mortality of GCA patients in comparison to non-vasculitis patients, then stratified by age, sex, and calendar year of cohort entry...
February 6, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29408476/a-case-of-giant-cell-arteritis-associated-with-a-culture-proven-coxiella-burnetii-aortitis
#8
S De Worm, J B Giot, C Courtoy, E Gillet, Sophie Amrane, P Huynen, M Van Esbroeck, E Prudent, H Lepidi, Matthieu Million, M Moutschen, Didier Raoult
We report a case of proven Coxiella burnetii aortitis, possibly associated with a giant cell arteritis (GCA). A seventy-two-year-old man, who is a hunter, presented with weight loss, fevers, jaw claudication and hardened temporal arteries associated with a persistent inflammatory syndrome and an arteritis of the whole aorta including the brachiocephalic arteries on the 18F-FDG PET/CT. A diagnosis of GCA was retained and a treatment with prednisolone was started. Given an aneurysm of the abdominal aorta, the patient underwent replacement of abdominal aorta with an allograft...
February 2, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29406202/diagnosis-and-management-of-headache-in-older-adults
#9
REVIEW
Amaal J Starling
Headache is a common, disabling neurologic problem in all age groups, including older adults. In older adults, headache is most likely a primary disorder, such as tension-type headache or migraine; however, there is a higher risk of secondary causes, such as giant cell arteritis or intracranial lesions, than in younger adults. Thus, based on the headache history, clinical examination, and presence of headache red flags, a focused diagnostic evaluation is recommended, ranging from blood tests to neuroimaging, depending on the headache characteristics...
February 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29394408/secukinumab-for-the-maintenance-of-glucocorticoid-free-remission-in-a-patient-with-giant-cell-arteritis-and-psoriatic-arthritis
#10
Žiga Rotar, Matija Tomšic, Alojzija Hocevar
No abstract text is available yet for this article.
January 30, 2018: Rheumatology
https://www.readbyqxmd.com/read/29392458/cerebrovascular-events-in-takayasu-arteritis-a-multicenter-case-controlled-study
#11
Priscille Couture, Thibaud Chazal, Charlotte Rosso, Julien Haroche, Anne Léger, Baptiste Hervier, Sandrine Deltour, Zahir Amoura, Fleur Cohen Aubart
OBJECTIVES: Takayasu arteritis (TA) is a giant cell arteritis usually affecting young women and characterized by inflammatory and ischemic signs of large vessel involvement, including extracranial cerebral arteries. The impact of stroke on TA prognosis has not been well evaluated. METHODS: We performed a retrospective multicenter review of patients with definite TA who experienced at least one stroke and compared the findings to 17 matched patients with TA diagnosis without neurological involvement...
February 1, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29391771/does-herpes-zoster-predispose-to-giant-cell-arteritis-a-geo-epidemiologic-study
#12
Edsel B Ing, Royce Ing, Xinyang Liu, Angela Zhang, Nurhan Torun, Michael Sey, Christian Pagnoux
Purpose: Giant cell arteritis (GCA) is the most common systemic vasculitis in the elderly and can cause irreversible blindness and aortitis. Varicella zoster (VZ), which is potentially preventable by vaccination, has been proposed as a possible immune trigger for GCA, but this is controversial. The incidence of GCA varies widely by country. If VZ virus contributes to the immunopathogenesis of GCA we hypothesized that nations with increased incidence of GCA would also have increased incidence of herpes zoster (HZ)...
2018: Clinical Ophthalmology
https://www.readbyqxmd.com/read/29384830/giant-cell-arteritis-and-malignancy-more-than-just-a-coincidence
#13
Rok Ješe, Žiga Rotar, Matija Tomšič, Alojzija Hočevar
No abstract text is available yet for this article.
January 30, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/29374629/cross-phenotype-analysis-of-immunochip-data-identifies-kdm4c-as-a-relevant-locus-for-the-development-of-systemic-vasculitis
#14
Lourdes Ortiz-Fernández, Francisco David Carmona, Raquel López-Mejías, Maria Francisca González-Escribano, Paul A Lyons, Ann W Morgan, Amr H Sawalha, Kenneth G C Smith, Miguel A González-Gay, Javier Martín
OBJETIVE: Systemic vasculitides represent a heterogeneous group of rare complex diseases of the blood vessels with a poorly understood aetiology. To investigate the shared genetic component underlying their predisposition, we performed the first cross-phenotype meta-analysis of genetic data from different clinically distinct patterns of vasculitis. METHODS: Immunochip genotyping data from 2465 patients diagnosed with giant cell arteritis, Takayasu's arteritis , antineutrophil cytoplasmic antibody-associated vasculitis or IgA vasculitis as well as 4632 unaffected controls were analysed to identify common susceptibility loci for vasculitis development...
January 27, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29372057/right-orbital-edema-masquerading-a-hematologic-malignancy
#15
Andrew C Tiu, Vivian Arguello-Guerra, Gabor Varadi
Introduction: Multiple myeloma is caused by abnormal proliferation of plasma cells that affects more commonly African Americans. It classically presents with hypercalcemia, renal failure, anemia, and lytic bone lesions. The aim of this article is to present an unusual case of a 63-year-old African-American female with multiple myeloma who presented with worsening right-sided eye swelling for the past 3 weeks and to briefly review ophthalmologic manifestations of multiple myeloma. Case description: Our patient's presentation was associated with a throbbing frontal headache, nasal congestion, malaise, and weight loss...
2018: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29362158/imaging-giant-cell-arteritis-and-aortitis-in-contrast-enhanced-18f-fdg-pet-ct-which-imaging-score-correlates-best-with-laboratory-inflammation-markers
#16
Susann-Cathrin Olthof, Patrick Krumm, Jörg Henes, Konstantin Nikolaou, Christian la Fougère, Christina Pfannenberg, Nina Schwenzer
PURPOSE: To define the most appropriate imaging parameters in combined Fluorodeoxyglucose (FDG) PET/CT reflecting the inflammatory burden in large vessel vasculitis. METHODS: Two readers retrospectively graded disease extent and activity in 17 LVV patients using visual and quantitative scores in FDG PET and contrast enhanced CT. Visual PET scores were assessed corresponding to FDG-uptake vs. liver uptake (score 0-3). CT visual scoring referred to the affected vessel extent (score 1-5)...
February 2018: European Journal of Radiology
https://www.readbyqxmd.com/read/29358285/eular-recommendations-for-the-use-of-imaging-in-large-vessel-vasculitis-in-clinical-practice
#17
Christian Dejaco, Sofia Ramiro, Christina Duftner, Florent L Besson, Thorsten A Bley, Daniel Blockmans, Elisabeth Brouwer, Marco A Cimmino, Eric Clark, Bhaskar Dasgupta, Andreas P Diamantopoulos, Haner Direskeneli, Annamaria Iagnocco, Thorsten Klink, Lorna Neill, Cristina Ponte, Carlo Salvarani, Riemer H J A Slart, Madeline Whitlock, Wolfgang A Schmidt
To develop evidence-based recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV) including giant cell arteritis (GCA) and Takayasu arteritis (TAK).European League Against Rheumatism (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound, MRI, CT and [18F]-fluorodeoxyglucose positron emission tomography (PET) in LVV. Based on evidence and expert opinion, the task force consisting of 20 physicians, healthcare professionals and patients from 10 EULAR countries developed recommendations, with consensus obtained through voting...
January 22, 2018: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/29357744/skin-limited-arteritis-of-small-muscular-arteries-with-giant-cell-rich-granulomatous-inflammation-in-a-patient-with-polymyalgia-rheumatica
#18
M Kobayashi, H Shimojo, K Shingu, M Harada, H Kanno
No abstract text is available yet for this article.
January 23, 2018: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/29352850/ultrasound-to-detect-involvement-of-vertebral-artery-in-giant-cell-arteritis
#19
Martin Gehlen, Nikolaus Schaefer, Michael Schwarz-Eywill, A Maier
No abstract text is available yet for this article.
January 11, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29349436/superficial-temporal-artery-aneurysm-associated-with-immunoglobulin-g4-related-disease
#20
Sosei Kuma, Tsubasa Takeshima, Takefumi Ohga, Tadahiro Nozoe, Katsuo Sueishi
A 68-year-old man was admitted because of a pulsatile mass and pain in the left temporal region, and computed tomography demonstrated the superficial temporal artery aneurysm. He underwent aneurysmectomy, and pathologic investigation revealed marked thickness of the adventitia with substantial plasmacyte infiltration. On immunoglobulin G4 (IgG4) immunohistochemistry, IgG4-positive lymphocytes were scattered in the adventitia, and biochemical tests revealed elevation of IgG4 (200 mg/dL). The case satisfied the criteria for both giant cell arteritis and IgG4-related disease (IgG4-RD)...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
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