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Temporal arteritis

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https://www.readbyqxmd.com/read/27908938/a-rare-case-of-extensive-cranial-langerhans-cell-histiocytosis-synchronously-presenting-as-otitis-externa-and-giant-cell-arteritis
#1
Adnan Darr, Zahir Mughal, Thomas Martin
Langerhans cell histiocytosis (LCH) is a rare histiocytic disorder of unpredictable clinical course and varied modes of presentation. The spectrum of presentation is wide, ranging from isolated eosinophilic granulomas to multiple lesions and diffuse systemic involvement. We present the case of a 52-year-old man, who presented with an 8-week history of worsening otalgia and superficial temporal tenderness attributed to otitis externa within the community and subsequently giant cell arteritis. Computed tomography and magnetic resonance imaging were undertaken due to atypical features, which demonstrated bony destruction within the right greater wing of the sphenoid, squamous part of temporal and mastoid bone, with middle cranial fossa communication...
December 1, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27855129/temporal-arteritis-with-arteritic-anterior-ischemic-optic-neuropathy-is-bilateral-until-proven-otherwise-response
#2
Neil R Miller, Tin Yan Alvin Liu
No abstract text is available yet for this article.
December 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27824543/giant-cell-arteritis-and-polymyalgia-rheumatica-2016-update
#3
REVIEW
Gideon Nesher, Gabriel S Breuer
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are both more common among people of North European decent than among Mediterranean people. Women are 2-3 times more commonly affected. Giant cell arteritis and PMR are extremely rare before age 50 years. Polymyalgia rheumatica may be "isolated" or associated with GCA. There is increased expression of inflammatory cytokines in temporal arteries of PMR patients, without overt histological evidence of arteritis. One-third of "isolated" PMR patients have vascular uptake in positron emission tomography (PET) scans, suggesting clinically unrecognized, "hidden" GCA...
October 31, 2016: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/27800647/value-of-temporal-artery-biopsy-length-in-diagnosing-giant-cell-arteritis
#4
Lawrence J Oh, Eugene Wong, Anthony J Gill, Peter McCluskey, James E H Smith
BACKGROUND: Giant cell arteritis (GCA) is considered an ophthalmological emergency with severe sight and life-threatening sequelae. Temporal artery biopsy (TAB) is the current gold standard for the diagnosis of GCA; however, the required length of biopsy remains an issue of contention in the literature. METHODS: Retrospective case-control study of a consecutive cohort of 545 patients who had undergone TABs across five hospitals between 1 January 1992 and 1 January 2016...
November 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27797882/visual-disturbance-with-systemic-symptoms-old-lessons-revisited
#5
Megan E Hume, Peter M Fernandes, Kirsty MacLean, Euan McRorie, Richard Davenport
We describe a retired physician who presented with visual disturbance and systemic symptoms. The presence of general malaise, headache and scalp tenderness, with raised inflammatory markers, suggested that giant cell arteritis (GCA) was the likely diagnosis. Rapid response to initial steroid therapy and histological evidence of inflammation in the temporal artery supported this diagnosis. The character of these visual symptoms was, however, atypical for GCA. The patient, who had heart valve disease, subsequently deteriorated and developed further symptoms warranting investigation of bacterial endocarditis...
October 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27777334/secondary-merkel-cell-carcinoma-arising-from-a-graft-donor-site
#6
Fatima Aloraifi, Stephen Mulgrew, Nick K James
Merkel cell carcinoma (MCC) is a highly aggressive cutaneous neuroendocrine tumour that is increasing in incidence. We report a case of a 92-year-old white man on long-term immunosuppression for temporal arteritis who presented with a Merkel cell tumour on his left cheek. A wide local excision was performed and the defect was reconstructed with a full-thickness skin graft. Four years later, the patient re-presented with a Merkel cell tumour arising from the right supraclavicular donor site. To our knowledge, this is the first report of a recurrence of MCC into a donor site...
October 24, 2016: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/27740619/the-use-of-transdermal-optical-coherence-tomography-to-image-the-superficial-temporal-arteries
#7
S P Mollan, P A Keane, A K Denniston
PurposeThe diagnosis of Giant Cell Arteritis (GCA) is an area of major challenge. This is the first reported use of the directed use of transdermal optical coherence tomography (OCT) to image the superficial temporal artery (STA).MethodsThis proof of concept study used a commercially available transdermal OCT instrument to identify and image the STA in eight patients (suspected GCA, confirmed GCA, and in healthy controls). Three cases are presented to demonstrate the preliminary imaging findings.ResultsIn all eight cases the STA was identified...
October 14, 2016: Eye
https://www.readbyqxmd.com/read/27699002/the-impact-of-temporal-artery-biopsy-on-surgical-practice
#8
Adam Thomas Cristaudo, Ryo Mizumoto, Rasika Hendahewa
BACKGROUND: Giant cell arteritis (GCA) has the potential to cause irreversible blindness and stroke in affected patients [1-4]. Temporal artery biopsy (TAB) remains the gold standard test for GCA [6-8]. Recent literature suggests that TAB does not change management of patients with suspected GCA and that ultrasound scan (USS) may be sufficient enough alone to confirm the diagnosis [9-11,13]. The aim of this study is to therefore determine the impact of TAB on current surgical practice and emergency theatre services...
November 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/27631531/-management-of-polymyalgia-rheumatica-and-large-vessel-vasculitis
#9
B Hellmich
Imaging methods, such as joint and color duplex sonography, magnetic resonance imaging (MRI) and positron emission tomography (PET) nowadays facilitate the diagnosis of polymyalgia rheumatica and large vessel vasculitides and have now been included in the new classification criteria. In patients with typical symptoms, color duplex sonography of the temporal artery can replace a biopsy of the temporal artery for the diagnosis of giant cell arteritis (GCA); however, the role of these methods for patient follow-up and assessment of prognosis is unclear...
November 2016: Der Internist
https://www.readbyqxmd.com/read/27606478/the-use-of-the-color-doppler-ultrasonography-in-the-diagnosis-and-monitoring-of-an-atypical-case-of-giant-cell-arteritis
#10
N Martins, J Polido-Pereira, A M Rodrigues, F Soares, P Batista, J A Pereira da Silva
Giant Cell Arteritis (GCA) is a large vessels vasculitis that is typically characterised by headache, scalp tenderness, jaw claudication and visual disturbances. Temporal arteries color Doppler ultrasonography (CDUS) is a sensitive and non-invasive image technique used in the diagnosis of this disease. This work highlights the importance of CDUS in the diagnostic workup of GCA and also demonstrates it´s usefullness in the evaluation and documentation of the response to corticosteroids therapy in an atypical case of ACG...
April 2016: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/27558589/the-effect-of-clinical-features-and-glucocorticoids-on-biopsy-findings-in-giant-cell-arteritis
#11
Karin Jakobsson, Lennart Jacobsson, Aladdin J Mohammad, Jan-Åke Nilsson, Kenneth Warrington, Eric L Matteson, Carl Turesson
BACKGROUND: To investigate the effect of baseline clinical characteristics and glucocorticoid treatment on temporal artery biopsy (TAB) findings in patients with giant cell arteritis (GCA). METHODS: Individuals who developed GCA after inclusion in two population-based health surveys were identified through linkage to the local and the national patient registers. In addition, other patients diagnosed with GCA at the Departments of Internal Medicine and Rheumatology at an area hospital were included...
2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27556960/diagnosing-light-chain-amyloidosis-on-temporal-artery-biopsies-for-suspected-giant-cell-arteritis
#12
Rosanna A M Ghinai, Shameem Mahmood, Pinias Mukonoweshuro, Sally Webber, Ashutosh D Wechalekar, Sally E Moore
Although still rarely diagnosed, amyloid light chain (AL) amyloidosis is the most common form of systemic amyloidosis. It is characterized by misfolded monoclonal immunoglobulin light chain fragments that accumulate extracellularly as amyloid fibrils, with consequent organ dysfunction. We report 2 such cases where initial symptoms and signs were identical to and mistaken for those of giant cell arteritis, associated with polymyalgia rheumatica. Neither patient responded to high-dose corticosteroids; instead, their temporal artery biopsies revealed amyloid deposits and other investigations confirmed a diagnosis of systemic AL amyloidosis...
August 23, 2016: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/27523011/giant-cell-arteritis-which-developed-after-the-administration-of-granulocyte-colony-stimulating-factor-for-cyclic-neutropenia
#13
Masataka Umeda, Jin Ikenaga, Tomohiro Koga, Toru Michitsuji, Toshimasa Shimizu, Shoichi Fukui, Ayako Nishino, Yoshikazu Nakasima, Sin-Ya Kawashiri, Naoki Iwamoto, Kunihiro Ichinose, Yasuko Hirai, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Atsushi Kawakami
A 78-year-old woman diagnosed with cyclic neutropenia 5 years previously had been treated with recombinant granulocyte-colony stimulating factor (G-CSF). She developed fever, tenderness and distension of temporal arteries after the treatment with G-CSF. Magnetic resonance imaging and ultrasonography revealed wall thickening of the temporal arteries. She was therefore diagnosed with giant cell arteritis (GCA). Small vessel vasculitis has been reported as a complication of G-CSF. However, the development of large vessel vasculitis after G-CSF treatment is quite rare...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27516038/clinical-and-color-doppler-imaging-features-of-one-patient-with-occult-giant-cell-arteritis-presenting-arteritic-anterior-ischemic-optic-neuropathy
#14
Dragoş Cătălin Jianu, Silviana Nina Jianu, Ligia Petrica, Andrei Gheorghe Marius Motoc, Traian Flavius Dan, Dorela CodruŢa Lăzureanu, Mihnea Munteanu
Anterior ischemic optic neuropathies (AIONs) represent a segmental infarction of the optic nerve head (ONH) supplied by the posterior ciliary arteries (PCAs). Blood supply blockage can occur with or without arterial inflammation. For this reason, there are two types of AIONs: non-arteritic (NA-AION), and arteritic (A-AION), the latter is almost invariably due to giant cell arteritis (GCA). GCA is a primary vasculitis that predominantly affects extracranial medium-sized arteries, particularly the branches of the external carotid arteries (including superficial temporal arteries - TAs)...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27499427/sustained-remission-after-long-term-biological-therapy-in-patients-with-large-vessel-vasculitis-an-analysis-of-ten-cases
#15
Juan P Vinicki, Rosario García-Vicuña, Miguel Arredondo, Juan P López-Bote, Jesús A García-Vadillo, Santos Castañeda, José M Álvaro-Gracia
OBJECTIVES: To describe the results obtained in clinical practice with the use of biological therapy (BT) in patients diagnosed with Takayasu arteritis (TA) and giant cell arteritis (GCA). METHODS: Retrospective single center study of TA/GCA patients who received BT (infliximab [IFX], etanercept [ETN] and tocilizumab [TCZ]). In TA, active disease was defined according to a previous National Institutes of Health study. In GCA, active disease was defined with a modified criteria and clinical manifestations secondary to temporal artery involvement or polymyalgia rheumatica symptoms...
August 4, 2016: Reumatología Clinica
https://www.readbyqxmd.com/read/27477419/giant-cell-arteritis-with-facial-edema-presenting-with-delayed-jugular-venous-flow
#16
Yohei Kanzawa, Yasushi Mizuno, Yukihiro Imai, Hiroaki Nishioka
The detection of abnormalities of the cranial arteries on magnetic resonance imaging (MRI) is useful for the diagnosis of giant cell arteritis (GCA). However, reports on the veins of GCA patients are rare. We report the case of an elderly woman with GCA who presented with facial edema. She presented with a one month history of headache and facial edema. After MRI and enhanced computed tomography revealed delayed blood flow in the left jugular vein, a temporal artery biopsy was performed. She was diagnosed with GCA based on the biopsy findings...
2016: Internal Medicine
https://www.readbyqxmd.com/read/27472684/positron-emission-tomography-and-computed-tomography-angiography-for-the-diagnosis-of-giant-cell-arteritis-a-real-life-prospective-study
#17
Delphine Lariviere, Khadija Benali, Baptiste Coustet, Nicoletta Pasi, Fabien Hyafil, Isabelle Klein, Maria Chauchard, Jean-François Alexandra, Tiphaine Goulenok, Antoine Dossier, Philippe Dieude, Thomas Papo, Karim Sacre
The use of 18F-fluoro-deoxyglucose positron emission tomography scan (FDG-PET) and computed tomography angiography (CTA) to improve accuracy of diagnosis of giant cell arteritis (GCA) is a very important clinical need. We aimed to compare the diagnostic performance of FDG-PET and CTA in patients with GCA.FDG-PET and CTA were acquired in all consecutive patients suspected for GCA. Results of FDG-PET and CTA were compared with the final diagnosis based on clinical judgment, temporal artery biopsy (TAB) findings, and ACR criteria...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27445262/is-all-inflammation-within-temporal-artery-biopsies-temporal-arteritis
#18
Liwei Jia, Marta Couce, Jill S Barnholtz-Sloan, Mark L Cohen
Temporal arteritis peaks during the 8th decade, affecting patients with frequent comorbidities who are especially prone to adverse effects of corticosteroid therapy. Perivascular inflammation involving small periadventitial vessels is not uncommon in otherwise normal temporal artery biopsies (TAB). As ischemic events occur in patients with non-temporal artery based inflammation, it has been recommended any vascular inflammation within temporal artery biopsies be treated with corticosteroids. We sought to determine whether such patients are at increased risk for temporal arteritis-like adverse events compared with age-matched controls devoid of inflammatory infiltrates...
July 18, 2016: Human Pathology
https://www.readbyqxmd.com/read/27440169/association-between-specimen-length-and-diagnostic-yield-of-temporal-artery-biopsy
#19
C Grossman, I Ben-Zvi, I Barshack, G Bornstein
OBJECTIVES: Temporal artery biopsy (TAB) is performed in patients suspected of giant cell arteritis (GCA). Inadequate TAB specimen length is considered a possible explanation for a negative biopsy in patients with GCA. We investigated the association between specimen length and diagnostic yield of TAB. METHOD: We conducted a retrospective analysis of 240 patients who underwent TAB in a single hospital between 2000 and 2015. Patients were diagnosed with GCA based on positive TAB or, when TAB was negative, on clinical grounds that fulfilled the American College of Rheumatology (ACR) 1990 criteria...
July 20, 2016: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/27421223/giant-cell-arteritis
#20
REVIEW
Jem Ninan, Susan Lester, Catherine Hill
Giant cell arteritis (GCA) is the most common vasculitis of the elderly. The diagnosis can be challenging at times because of the limitation of the American Rheumatology Association (ARA) classification criteria and the significant proportion of biopsy-negative patients with GCA. We discuss the role of advanced imaging techniques, including positron emission tomography (PET) scanning, in establishing diagnosis and improved histopathology techniques to improve the sensitivity of temporal artery biopsy. There have been significant advances in the understanding of the pathogenesis of GCA, particularly the role of cytokine pathways such as the interleukins, IL-6-IL-17 axis, and the IL-12-interferon-γ axis and their implication for new therapies...
February 2016: Best Practice & Research. Clinical Rheumatology
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