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Temporal arteritis

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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
#1
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
#2
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
#3
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/28405470/is-vascular-endothelial-growth-factor-a-useful-biomarker-in-giant-cell-arteritis
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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/28332442/ultrasound-imaging-in-the-diagnosis-of-large-vessel-vasculitis
#11
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/28315516/metaplastic-ossification-of-the-temporal-artery-with-osteoclast-like-giant-cells-a-mimicker-of-giant-cell-temporal-arteritis
#12
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/28275606/studies-on-the-histopathology-of-temporal-arteritis
#13
Angeline L Wang, Meisha L Raven, Krishna Surapaneni, Daniel M Albert
AIMS: The aim of this paper was to identify the location and to grade the severity of most significant inflammation within positive temporal artery biopsies along with other key clinical and histologic characteristics. METHODS: Charts and pathology slides for 70 patients diagnosed with temporal arteritis at the University of Wisconsin (UW) Hospital and Clinics from 1989 to 2015 were reviewed. A subset of 48 specimens was immunostained for CD68 and graded on a scale from 0 to +++; the location of staining was recorded...
January 2017: Ocular Oncology and Pathology
https://www.readbyqxmd.com/read/28274481/no-detection-of-varicella-zoster-virus-in-temporal-arteries-of-patients-with-giant-cell-arteritis
#14
Francesco Muratore, Stefania Croci, Ione Tamagnini, Alessandro Zerbini, Salvatore Bellafiore, Lucia Belloni, Luigi Boiardi, Alessandra Bisagni, Nicolò Pipitone, Maria Parmeggiani, Alberto Cavazza, Carlo Salvarani
OBJECTIVE: Data on the presence of varicella-zoster virus (VZV) in temporal arteries of patients with giant cell arteritis (GCA) are controversial. We analyzed VZV infection in temporal arteries from Italian patients with temporal artery biopsy (TAB)-positive GCA, TAB-negative GCA, and controls. METHODS: A total of 79 formalin-fixed, paraffin-embedded (FFPE) TABs performed between 2009 and 2012 at a single institution from 34 TAB-positive GCA patients, 15 TAB-negative GCA patients, and 30 controls were retrieved...
February 10, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/28258302/-ultrasound-biomicroscopy-in-giant-cell-arteritis
#15
M Pattmöller, L Daas, A Viestenz, G Milioti, A Hasenfus, B Seitz, A Viestenz
Giant cell arteritis may lead to irreversible blindness due to an anterior ischemic optic neuropathy or central retinal artery occlusion. Diagnosis of the giant cell arteritis is sometimes a problem: Difficulties may arise since a negative biopsy can not rule out the diagnosis. This case report demonstrates acute changes in the temporal artery as demonstrated by Ultrasound Biomicroscopy and documents its course during therapy with corticosteroids.
March 3, 2017: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/28256573/clinical-and-pathological-evolution-of-giant-cell-arteritis-a-prospective-study-of-follow-up-temporal-artery-biopsies-in-40-treated-patients
#16
Joseph J Maleszewski, Brian R Younge, John T Fritzlen, Gene G Hunder, Jorg J Goronzy, Kenneth J Warrington, Cornelia M Weyand
Although clinical signs and symptoms of giant cell arteritis improve promptly after starting glucocorticoid therapy, reports have suggested that the vascular inflammation may persist. To assess the duration and quality of histopathologic changes in treated patients, we prospectively obtained second temporal artery biopsies in patients treated for 3 to 12 months after their first diagnostic biopsy. Forty patients (28 women, 12 men, median age 77 years) agreed to have a second temporal artery biopsy randomly assigned to 3, 6, 9, or 12 months subsequent to the first...
March 3, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28244857/diagnostic-validity-of-doppler-ultrasound-in-giant-cell-arteritis
#17
I Concepción Aranda-Valera, Sara García Carazo, Irene Monjo Henry, Eugenio De Miguel Mendieta
OBJECTIVES: To assess the validity of Doppler ultrasound in the diagnosis of giant cell arteritis (GCA), using the American College of Rheumatology (ACR) criteria and biopsy and using as gold standard the patient's definitive clinical diagnosis. METHODS: An observational, descriptive and analytical study of 451 consecutive patients with suspected GCA was conducted, and the clinical history and ultrasound findings of the patients were reviewed. The validity of ACR criteria, temporal arteritis biopsy (TAB) and Doppler ultrasound in the diagnosis of GCA was calculated using the final diagnosis of the doctor in charge as the gold standard...
February 28, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28138903/the-treatment-of-giant-cell-arteritis
#18
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
#19
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
#20
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
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