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Beenish Fayyaz
Carotid atherosclerosis and giant cell arteritis (GCA) are two distinct medical conditions with an overlapping clinical spectrum of vascular symptoms such as vision loss and ischemic stroke. This is because both diseases cause arterial ischemia with a predilection for carotid vasculature. In addition, high-vascular risk individuals who are diagnosed with GCA are usually elderly with age >55 years with high-vascular risk and thus can have underlying atherosclerosis. All these factors can pose a diagnostic dilemma for the physicians as GCA is a medical emergency which if left untreated can result in significant morbidity and mortality...
2018: Journal of Community Hospital Internal Medicine Perspectives
Stefania Bianchi Marzoli, Alessandra Criscuoli
Pain occurs with optic neuropathies associated with inflammatory central nervous system diseases (MS and NMO), idiopathic intracranial hypertension and spontaneous hypotension, giant cell arteritis, immunomediated systemic diseases, compressive lesions, or infective disorders. Pain can precede the onset of visual loss in acute optic neuritis, it can be irradiated to the orbital region in giant cell arteritis and parasellar compressive optic neuropathies, or it may be located to the back of the eye with posterior scleritis...
June 2018: Neurological Sciences
Diana Prieto-Peña, Isabel Martínez-Rodríguez, Javier Loricera, Ignacio Banzo, Mónica Calderón-Goercke, Vanesa Calvo-Río, Carmen González-Vela, Alfonso Corrales, Santos Castañeda, Ricardo Blanco, José L Hernández, Miguel Á González-Gay
OBJECTIVE: Polymyalgia rheumatica (PMR) is often the presenting manifestation of giant cell arteritis (GCA). Fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) scan often discloses the presence of large vessel vasculitis (LVV) in PMR patients. We aimed to identify predictive factors of a positive PET/CT scan for LVV in patients classified as having isolated PMR according to well-established criteria. METHODS: A set of consecutive patients with PMR from a single hospital were assessed...
May 18, 2018: Seminars in Arthritis and Rheumatism
Yongjing Cheng, Xiaozhen Zhao, Yuling Chen, Yuhui Li, Rulin Jia, Lei Zhu, Cibo Huang, Xiaolin Sun, Haiteng Deng, Zhanguo Li
BACKGROUND: Behcet's disease (BD) is a chronic, multisystem-involved vasculitis and its pathogenesis remains elusive. No specific serological markers for BD diagnosis have been established. Identification of novel diagnostic biomarkers will be helpful in timely diagnostic and treatment for Behcet's disease. OBJECTIVE: To screen novel autoantigens or autoantibodies with potential diagnostic value in circulating immune complexes (CICs) from BD patients. METHODS: A proteomic strategy for immune complexome analysis was developed, in which CICs were separated from serum sample of 10 BD patients and 10 healthy controls and then subjected to Orbitrap mass spectrometry for autoantigen profiling...
2018: PloS One
Jin Lv, Qiankun Zhang
Cryptococcal meningitis is a rare complication of giant cell vasculitis. Because its manifestations are very similar to those of giant cell vasculitis relapse, the diagnosis is often delayed and/or misdiagnosed. In this article, we present the case of a 65-year-old female patient who suffered from cryptococcal meningitis during high-dose steroid therapy for giant cell vasculitis.
December 2017: Archives of Rheumatology
D M Girgis, D J Gibson, C J Wood, S S Subramaniam, A M Bobinskas
Biopsy of the superficial temporal artery is often used in the diagnosis of giant cell arteritis, but at traditional sites there is a risk of injury to the facial nerve. Recently the Gillies incision has been suggested as an alternative means of access for the biopsy, but the anatomical basis of this has not been fully elucidated. We therefore undertook a radiographic review of 150 patients, and examining 300 vessels, to find out. Our results indicated that there is considerable variability in the position of the bifurcation of the superficial temporal artery, and so a Gillies approach may not be reliable, particularly if access to the bifurcation is required...
June 9, 2018: British Journal of Oral & Maxillofacial Surgery
Juliane Comunello, Suely Akiko Nakagawa, Felipe D'Almeida Costa, Wagner Santana Cerqueira, Wu Tu Chung, Fábio Fernando Eloi Pinto
Primary osseous angiosarcoma is a rare entity with variable biological behavior and poor prognosis. Little is known about the oncologic treatment and its etiology is still unknown. This study presents a case of lytic lesion in the right femur with dissemination to other bones, such as the vertebral column and skull, and to the lungs and central nervous system. Orthopedic surgery was performed in order to improve quality of life. Surgical specimen confirmed the diagnosis of high-grade malignant osseous angiosarcoma...
May 2018: Revista Brasileira de Ortopedia
Harris Sultan, Stacy V Smith, Andrew G Lee, Patricia Chévez-Barrios
PURPOSE: To provide quantitative evidence linking the Cluster of Differentiation-68 (CD68)+ macrophage-marker found on temporal artery biopsies (TABs) with disease prognosis. DESIGN: Retrospective, cross-sectional study METHODS: We examined 42 consecutive patients who had undergone unilateral TABs at a single hospital in 2015. Clinical data, laboratory data, and histopathologic features of TABs were recorded. INCLUSION CRITERIA: clinical diagnosis of giant cell arteritis (GCA) with TAB performed at the same center...
June 8, 2018: American Journal of Ophthalmology
Berivan Emsen, Khadija Benali, Besma Mahida, Delphine Larivière, Dominique Le Guludec, Thomas Papo, Karim Sacre, Fabien Hyafil
INTRODUCTION: The choice of metrics for defining active Takayasu arteritis (TAK) using fluorine-18-fluorodeoxyglucose (F-FDG)-PET remains controversial. OBJECTIVE: The aim of this study was to compare in the same patients the diagnostic performance for the detection of active TAK of different metrics applied for the quantification of vascular F-FDG uptake with PET. PATIENTS AND METHODS: Overall, 62 PET acquisitions were performed 90 min after F-FDG injection in 15 patients with TAK and analyzed retrospectively...
June 8, 2018: Nuclear Medicine Communications
Leonard Shan, David Goh, Timothy Wagner
INTRODUCTION: Type 1 Takayasu's arteritis (TA) predominantly affects the supra-aortic branches. Occlusive disease can cause catastrophic complications such as stroke and death. Open and endovascular techniques of revascularisation are described for extracranial disease. There is currently no default choice of surgical intervention. Furthermore, the management of distal intracranial complications has not been described. PRESENTATION OF CASE: A 25-year-old lady with known TA on immunosuppression presents with acute left middle cerebral artery (MCA) stroke...
June 7, 2018: Annals of Vascular Surgery
Jasvinder A Singh, John D Cleveland
OBJECTIVES: To assess whether gout is associated with a higher or lower risk of a new diagnosis of giant cell arteritis (GCA) in older adults, adjusting for known risk factors of GCA. METHODS: We used the 5% Medicare claims to conduct a multivariable Cox regression analyses to assess the association of gout with incident GCA in adults 65 years or older adjusting for age, gender, race (known risk factors for GCA) and Charlson-Romano comorbidity score, the use of medications for cardiovascular diseases (statins, beta-blockers, diuretics, ACE-inhibitors) and gout (allopurinol, febuxostat)...
June 7, 2018: Joint, Bone, Spine: Revue du Rhumatisme
Tanaz A Kermani, Sehriban Diab, Antoine G Sreih, David Cuthbertson, Renée Borchin, Simon Carette, Lindsy Forbess, Curry L Koening, Carol A McAlear, Paul A Monach, Larry Moreland, Christian Pagnoux, Philip Seo, Robert F Spiera, Kenneth J Warrington, Steven R Ytterberg, Carol A Langford, Peter A Merkel, Nader A Khalidi
OBJECTIVES: To evaluate large-vessel (LV) abnormalities on serial imaging in patients with giant cell arteritis (GCA) and discern predictors of new lesions. METHODS: Clinical and imaging data from patients with GCA (including subjects diagnosed by LV imaging) enrolled in a prospective, multicenter, longitudinal study and/or a randomized clinical trial were included. New arterial lesions were defined as a lesion in a previously unaffected artery. RESULTS: The study included 187 patients with GCA, 146 (78%) female, mean (±SD) age at diagnosis 68...
May 9, 2018: Seminars in Arthritis and Rheumatism
Daiki Kobayashi, Yasuhiro Suyama, Yasuhiro Osugi, Hiroko Arioka, Osamu Takahashi, Nagato Kuriyama
BACKGROUND: The hypothesis that patients with polymyalgia rheumatica (PMR) or giant cell arteritis (GCA) have a high risk for future cardiovascular diseases has not been adequately tested. The aim of this study is to evaluate this hypothesis in Japan, where the prevalence and severity of PMR and GCA are the lowest. METHODS: A propensity score matched cohort study was conducted at St. Luke's International Hospital, Tokyo, Japan, from 2003 to 2016. We included all patients who were diagnosed as PMR or GCA cases and matched comparators with a proportion of 1 : 2...
June 2018: International Journal of Rheumatic Diseases
Aicha Ben Tekaya, Mohamed Ben Hammamia, Raoudha Tekaya, Malek Ben Mrad, Raouf Denguir, Leila Abdelmoula
INTRODUCTION: While open repair was the gold standard treatment of atherosclerotic abdominal aortic aneurysms, its place in the treatment of inflammatory aortic aneurysms remains controversial. AIM: To specify the place of endovascular repair in the treatment of inflammatory aneurysms. OBSERVATION: We report 2 cases of inflammatory aortic aneurysms. The first patient was followed for Behçet's disease and the other patient for Giant Cell arteritis 's disease...
December 2017: La Tunisie Médicale
Yaping Joyce Liao, Sachin Kedar
No abstract text is available yet for this article.
June 5, 2018: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Miguel A González-Gay, Trinitario Pina, Diana Prieto-Peña, Mónica Calderon-Goercke, Ricardo Blanco, Santos Castañeda
Giant cell arteritis (GCA) is the most common large-vessel vasculitis in individuals older than 50 years from Western countries. The goal of the treatment is to achieve improvement of symptoms and clinical remission as well as decrease the risk of severe vascular complications. Areas covered: The review summarizes the main epidemiological and clinical features of GCA and discusses in depth both the classic and the new therapies used in the management of GCA. Expert commentary: Prednisone/prednisolone of 40-60 mg/day is the mainstay in GCA therapy...
June 7, 2018: Expert Review of Clinical Immunology
Haitham H Hassane, Mirza M Beg, Chokkalingam Siva, Celso Velázquez
BACKGROUND Systemic vasculitis can present with a multitude of symptoms involving multiple organ systems. Clinicians should avoid anchoring bias and be cognizant that different types of vasculitides can be present in the same patient and that the diagnosis of one should not preclude the subsequent diagnosis of another. CASE REPORT A 67-year-old woman was referred for evaluation of episodes of epistaxis and recurrent severe sinusitis. Her physical examination showed nasal congestion and purpuric rash on the lower extremities...
June 6, 2018: American Journal of Case Reports
Paula Estrada Alarcón, Dèlia Reina, Vanessa Navarro Ángeles, Dacia Cerdà, Daniel Roig-Vilaseca, Hèctor Corominas
BACKGROUND AND OBJECTIVE: Giant cell arteritis (GCA) is the most frequent systemic vasculitis in adults. In recent years, the usefulness of temporal artery ultrasound (TAUS) as a diagnostic tool to assess the underlying inflammation of the vascular wall during the inflammatory process has been under clinical investigation. MATERIAL AND METHODS: Observational and descriptive cohort study of 120 TAUS in 60 patients with clinical suspicions of GCA, according to the ACR (American College of Rheumatology) classification criteria...
June 2, 2018: Medicina Clínica
Christian von Kiel, Matthias Dreher, Konstantinos Triantafyllias, Peter Heinz, Andreas Schwarting
BACKGROUND: Giant cell arteritis (GCA) is one of the most common forms of inflammatory vasculitis in older patients. Because of possible irreversible vision deterioration, a fastest possible diagnosis and therapy is of absolute importance. To date, there are still no reliable data to obtain an initial assessment of the outpatient health care situation of patients diagnosed with GCA in Rhineland-Palatinate. METHODS: The specialists (neurologists, rheumatologists, ophthalmologists and general practitioners) participating in the statewide rheumatology network ADAPTHERA were questioned with the help of a questionnaire regarding disease frequency, activity, drug therapy and possible comorbidities...
June 4, 2018: Zeitschrift Für Rheumatologie
Stavros Chrysidis, Christina Duftner, Christian Dejaco, Valentin S Schäfer, Sofia Ramiro, Greta Carrara, Carlo Alberto Scirè, Alojzija Hocevar, Andreas P Diamantopoulos, Annamaria Iagnocco, Chetan Mukhtyar, Cristina Ponte, Esperanza Naredo, Eugenio De Miguel, George A Bruyn, Kenneth J Warrington, Lene Terslev, Marcin Milchert, Maria Antonietta D'Agostino, Mattew J Koster, Naina Rastalsky, Petra Hanova, Pierluigi Macchioni, Tanaz A Kermani, Tove Lorenzen, Uffe Møller Døhn, Ulrich Fredberg, Wolfgang Hartung, Bhaskar Dasgupta, Wolfgang A Schmidt
Objectives: To define the elementary ultrasound (US) lesions in giant cell arteritis (GCA) and to evaluate the reliability of the assessment of US lesions according to these definitions in a web-based reliability exercise. Methods: Potential definitions of normal and abnormal US findings of temporal and extracranial large arteries were retrieved by a systematic literature review. As a subsequent step, a structured Delphi exercise was conducted involving an expert panel of the Outcome Measures in Rheumatology (OMERACT) US Large Vessel Vasculitis Group to agree definitions of normal US appearance and key elementary US lesions of vasculitis of temporal and extracranial large arteries...
2018: RMD Open
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