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https://www.readbyqxmd.com/read/28138903/the-treatment-of-giant-cell-arteritis
#1
REVIEW
Imran Jivraj, Madhura Tamhankar
Giant cell arteritis (GCA) is a systemic inflammatory vasculitis affecting medium and large vessels with potentially sight and life-threatening complications. Early diagnosis and prompt treatment are imperative in order to prevent vision loss and progression of the disease. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are inflammatory markers which are elevated in the majority of patients and support the diagnosis of GCA among patients who present with typical symptoms. GCA is confirmed with superficial temporal artery biopsy which demonstrates characteristic pathological findings...
January 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28115719/immunoinhibitory-checkpoint-deficiency-in-medium-and-large-vessel-vasculitis
#2
Hui Zhang, Ryu Watanabe, Gerald J Berry, Augusto Vaglio, Yaping Joyce Liao, Kenneth J Warrington, Jörg J Goronzy, Cornelia M Weyand
Giant cell arteritis (GCA) causes autoimmune inflammation of the aorta and its large branches, resulting in aortic arch syndrome, blindness, and stroke. CD4(+) T cells and macrophages form organized granulomatous lesions in the walls of affected arteries, destroy the tunica media, and induce ischemic organ damage through rapid intimal hyperplasia and luminal occlusion. Pathogenic mechanisms remain insufficiently understood; specifically, it is unknown whether the unopposed activation of the immune system is because of deficiency of immunoinhibitory checkpoints...
February 7, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28088886/-tongue-necrosis-as-an-uncommon-manifestation-of-temporal-arteritis
#3
Zoltán Sámson, Beáta Gábor, Petra Görög, Csaba Tóth, Ákos Rőthy, Zoltán Lőcsei
Authors present a rare manifestation of the temporal arteritis, wich caused initial diagnostic difficulties, but it responded well for corticosteroid treatment. The features of the disease, pathogenesis, possible therapy are briefly summarized beside the description of clinical course. Orv. Hetil., 2017, 158(2), 77-80.
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28040246/risk-of-mortality-in-patients-with-giant-cell-arteritis-a-systematic-review-and-meta-analysis
#4
REVIEW
Catherine L Hill, Rachel J Black, Johannes C Nossent, Carlee Ruediger, Leanne Nguyen, Jem V Ninan, Susan Lester
BACKGROUND: Previous studies of mortality associated with GCA have shown conflicting results. We conducted a systematic review and meta-analysis to determine the mortality risk in GCA patients compared to the general population. METHODS: We searched for published studies indexed in MEDLINE and EMBASE and the Cochrane database from inception to June 18, 2015 using the terms "giant cell arteritis" and "temporal arteritis" combined with the terms for death, mortality, and survival...
August 25, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28029234/temporal-trends-of-venous-thromboembolism-risk-before-and-after-diagnosis-of-giant-cell-arteritis
#5
Sebastian Unizony, Na Lu, Gunnar Tomasson, Yuqing Zhang, Peter A Merkel, John H Stone, J Antonio Aviña-Zubieta, Hyon K Choi
OBJECTIVE: Giant cell arteritis (GCA) and the use of glucocorticoids have both been associated with increased risk of venous thromboembolism (VTE). However, the possibility of confounding by indication has not been investigated. We undertook this study to examine the temporal risk of VTE in GCA patients before and after GCA diagnosis, accounting for confounders including glucocorticoid treatment. METHODS: We conducted a matched cohort study using an electronic medical record database representative of the UK population (1990-2013)...
January 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/27998620/newly-diagnosed-vs-relapsing-giant-cell-arteritis-baseline-data-from-the-giacta-trial
#6
Katie Tuckwell, Neil Collinson, Sophie Dimonaco, Micki Klearman, Daniel Blockmans, Elisabeth Brouwer, Maria C Cid, Bhaskar Dasgupta, Juergen Rech, Carlo Salvarani, Sebastian H Unizony, John H Stone
OBJECTIVE: To report entry criteria and clinical features of patients with newly diagnosed and relapsing giant cell arteritis (GCA) enrolled in a randomized trial of tocilizumab, an interleukin-6 receptor-alpha inhibitor. METHODS: Newly diagnosed GCA was defined as diagnosis ≤6 weeks before baseline. Relapsing GCA was defined as diagnosis >6 weeks before baseline with ≥2 consecutive weeks of prednisone ≥40mg/day. All patients had active GCA within 6 weeks of baseline...
November 15, 2016: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/27997828/a-mechanism-for-controlled-breakage-of-under-replicated-chromosomes-during-mitosis
#7
Heike Duda, Meret Arter, Jiradet Gloggnitzer, Federico Teloni, Philipp Wild, Miguel G Blanco, Matthias Altmeyer, Joao Matos
While DNA replication and mitosis occur in a sequential manner, precisely how cells maintain their temporal separation and order remains elusive. Here, we unveil a double-negative feedback loop between replication intermediates and an M-phase-specific structure-selective endonuclease, MUS81-SLX4, which renders DNA replication and mitosis mutually exclusive. MUS81 nuclease is constitutively active throughout the cell cycle but requires association with SLX4 for efficient substrate targeting. To preclude toxic processing of replicating chromosomes, WEE1 kinase restrains CDK1 and PLK1-mediated MUS81-SLX4 assembly during S phase...
December 19, 2016: Developmental Cell
https://www.readbyqxmd.com/read/27994267/widespread-headache-as-the-first-clinical-manifestation-of-giant-cell-arteritis-in-patients-affected-by-polymyalgia-rheumatica
#8
Ciro Manzo
INTRODUCTION: In giant cell arteritis (GCA) headache of new onset due to inflammatory involvement of the temporal artery (TA) represents a diagnostic criterion. A widespread headache (WH) with scalp tenderness due to cranial arteritis can represent another manifestation of GCA. MATERIAL AND METHODS: In 225 elderly patients with polymyalgia rheumatica (PMR) followed in our rheumatologic outpatient clinic from 2004 until June 2016, the frequency of WH as the first clinical manifestation of GCA was evaluated...
2016: Reumatologia
https://www.readbyqxmd.com/read/27938961/clinical-predictors-of-positive-temporal-artery-biopsy
#9
Andrew Toren, Ezekiel Weis, Vivek Patel, Bethany Monteith, Steven Gilberg, David Jordan
OBJECTIVE: We investigated the ability of known clinical signs and symptoms, as well as common laboratory tests, to correctly predict a positive temporal artery biopsy. DESIGN: A prospective cohort study. PARTICIPANTS: Consecutive patients in a tertiary referral centre undergoing temporal artery biopsy. METHODS: Clinical information was collected using a predesigned questionnaire. Pathology results and laboratory information were collected from digital patient records...
December 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/27925577/the-role-of-ultrasound-compared-to-biopsy-of-temporal-arteries-in-the-diagnosis-and-treatment-of-giant-cell-arteritis-tabul-a-diagnostic-accuracy-and-cost-effectiveness-study
#10
Raashid Luqmani, Ellen Lee, Surjeet Singh, Mike Gillett, Wolfgang A Schmidt, Mike Bradburn, Bhaskar Dasgupta, Andreas P Diamantopoulos, Wulf Forrester-Barker, William Hamilton, Shauna Masters, Brendan McDonald, Eugene McNally, Colin Pease, Jennifer Piper, John Salmon, Allan Wailoo, Konrad Wolfe, Andrew Hutchings
BACKGROUND: Giant cell arteritis (GCA) is a relatively common form of primary systemic vasculitis, which, if left untreated, can lead to permanent sight loss. We compared ultrasound as an alternative diagnostic test with temporal artery biopsy, which may be negative in 9-61% of true cases. OBJECTIVE: To compare the clinical effectiveness and cost-effectiveness of ultrasound with biopsy in diagnosing patients with suspected GCA. DESIGN: Prospective multicentre cohort study...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27908938/a-rare-case-of-extensive-cranial-langerhans-cell-histiocytosis-synchronously-presenting-as-otitis-externa-and-giant-cell-arteritis
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
January 2017: Eye
https://www.readbyqxmd.com/read/27699002/the-impact-of-temporal-artery-biopsy-on-surgical-practice
#18
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
#19
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
#20
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
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