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Temporal artery biopsy

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https://www.readbyqxmd.com/read/29120976/case-report-masquerading-large-vessel-giant-cell-arteritis
#1
Paul Jacquier, Raphael Wuarin, Carlo Chizzolini, Gabriele Thumann, Heimo Steffen, Argyrios Chronopoulos
SIGNIFICANCE: Large-vessel giant cell arteritis (GCA) can be a diagnostic dilemma for the eye care provider because it may not involve the typical cranial arteries. When any of its potential ocular complications are diagnosed, it is important to consider this unusual form of GCA. PURPOSE: To report an unusual ophthalmic presentation of large-vessel GCA with sequential bilateral anterior ischemic optic neuropathy and branch retinal artery occlusion. METHODS: A 65-year-old previously healthy woman experienced sequential bilateral anterior ischemic optic neuropathy with branch retinal artery occlusion in the absence of other signs and symptoms suggestive of cranial GCA...
November 9, 2017: Optometry and Vision Science: Official Publication of the American Academy of Optometry
https://www.readbyqxmd.com/read/29045738/the-proposed-role-of-ultrasound-in-the-management-of-giant-cell-arteritis-in-routine-clinical-practice
#2
Sara Monti, Alberto Floris, Cristina B Ponte, Wolfgang A Schmidt, Andreas P Diamantopoulos, Claudio Pereira, Sophie Vaggers, Raashid A Luqmani
Objective: To develop and explore a protocol for using colour duplex sonography (CDS) in the routine care of GCA. Methods: We tested CDS of temporal arteries and axillary arteries (AXs) on consecutive patients with suspected or established GCA, between July 2014 and September 2016. Results: We assessed 293 patients [age 72 (10), female/male 196/97], of whom 118 had clinically confirmed GCA. Seventy-three percent of patients had already received high-dose glucocorticoids (GCs) for 17 (33) days...
October 16, 2017: Rheumatology
https://www.readbyqxmd.com/read/29024675/tempo-ral-was-the-heart-of-the-matter
#3
Francesco Pellegrini, Daniele Cirone, Piernicola Machin, Rod Foroozan
A 71-year-old woman was admitted with fever, headache and weight loss associated with elevated inflammatory markers. She developed acute bilateral ophthalmoplegia and asymmetrical ptosis rapidly followed by anterior ischemic optic neuropathy. Although the first temporal artery biopsy (TAB) was negative, contralateral TAB revealed features consistent with giant cell arteritis. Even while under steroid therapy, the patient died a few days later from myocardial infarction. Acute bilateral complete ophthalmoplegia is a rare presentation of a limited number of possible diseases...
October 9, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/29016409/anterior-ischemic-optic-neuropathy-due-to-calciphylaxis
#4
Magne S Sivertsen, Erik H Strøm, Kim M A Endre, Øystein K Jørstad
A 72-year-old woman experienced anterior ischemic optic neuropathy in her left eye. The funduscopic and fluorescein angiographic findings were strongly suggestive of giant cell arteritis. Temporal artery biopsy revealed extensive calcification in the vessel wall consistent with calciphylaxis. This unusual disorder should be considered in the differential diagnosis of anterior ischemic optic neuropathy, particularly the arteritic form.
October 6, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28994265/recognition-of-giant-cell-arteritis-in-patients-with-polymyalgia-rheumatica-who-have-a-stroke-a-cautionary-tale
#5
Donald H Gutteridge, Frank L Mastaglia
An 82-year-old woman with polymyalgia rheumatica (PMR) on prednisone 7 mg daily was admitted to an acute stroke unit with a right homonymous hemianopia, a left posterior cerebral artery occlusion and occipital lobe infarct. She had raised inflammatory markers, did not have a temporal artery biopsy, and was discharged on the same dose of prednisone. After 21 months, off prednisone, her ophthalmologist, concerned about giant cell arteritis (GCA), restarted prednisone 40 mg daily, with rapid, profound visual improvement...
October 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28991098/five-year-old-boy-with-behavioral-changes-and-papilledema
#6
Radha Ram, Jeremy Y Jones, Carrie A Mohila, Veeral S Shah
A 5-year-old boy had initial symptoms of behavioral changes, nausea, vomiting, headache, weight loss, and progressive vision failure. Brain MRI revealed abnormal signal intensity in both optic nerves, the optic chiasm, the right medial temporal lobe, and tissues surrounding the right supraclinoid internal carotid artery with associated leptomeningeal and spinal cord enhancement. After nondiagnostic dural and spinal arachnoid biopsies, a temporal lobe biopsy was diagnostic for a rare malignant peripheral nerve sheath tumor...
October 5, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28987704/the-role-of-colour-doppler-ultrasonography-of-facial-and-occipital-arteries-in-patients-with-giant-cell-arteritis-a-prospective-study
#7
Rok Ješe, Žiga Rotar, Matija Tomšič, Alojzija Hočevar
OBJECTIVE: Colour Doppler Sonography (CDS) in giant cell arteritis (GCA) allows the study of involvement of cranial arteries other than the temporal arteries, which are inconvenient to biopsy, such as the facial (FaA), and occipital (OcA) arteries. We aimed to estimate the frequency of the FaA, and OcA involvement in GCA; and to explore the clinical characteristics of these subgroups of patients. METHODS: From 1 January 2014 to 31 December 2016 we prospectively performed a CDS of the FaA, and OcA in addition to the temporal (TA), and the extracranial supra-aortic arteries in all newly diagnosed patients suspected of having GCA...
October 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28968695/increased-expression-of-interleukin-22-in-patients-with-giant-cell-arteritis
#8
Alessandro Zerbini, Francesco Muratore, Luigi Boiardi, Francesco Ciccia, Martina Bonacini, Lucia Belloni, Alberto Cavazza, Luca Cimino, Antonio Moramarco, Riccardo Alessandro, Aroldo Rizzo, Maria Parmeggiani, Carlo Salvarani, Stefania Croci
Objectives: GCA is characterized by arterial remodelling driven by inflammation. IL-22 is an attractive cytokine which acts at the crosstalk between immune and stromal cells. We hypothesized that IL-22 might be induced in GCA and might be involved in disease pathogenesis. Methods: Patients subjected to temporal artery biopsies (TABs) naïve from therapy were enrolled: 27 biopsy-proven GCA, 8 biopsy-negative GCA, 21 biopsy-negative non-GCA patients. Expression of IL-22 was determined in TABs by immunohystochemistry, in plasma by ELISA, in peripheral blood mononuclear cells by real-time PCR and flow cytometry...
September 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/28953579/fluorine-18-fluoro-2-deoxyglucose-positron-emission-tomography-uptake-in-the-superficial-temporal-and-vertebral-arteries-in-biopsy-positive-giant-cell-arteritis
#9
Anthony Michael Sammel, Edward Hsiao, Leslie Schrieber, Beatrice Janssen, Peter Youssef, Clare L Fraser, Chih-Hung Kuo, Hamish Dunn, Dale L Bailey, Paul Roach, Geoffrey Schembri, Elizabeth Bailey, Katherine Nguyen, Peter Farmakis, Rodger Laurent
No abstract text is available yet for this article.
September 26, 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28937523/cytomegalovirus-retinitis-associated-with-occlusive-vasculopathy-in-an-elderly-human-immunodeficiency-virus-negative-man
#10
Kareem Moussa, Thuy Doan, Jay M Stewart, Jessica Shantha, John Gonzales, Nisha Acharya, Emmett T Cunningham
PURPOSE: To present a case of cytomegalovirus (CMV) retinitis associated with occlusive vasculopathy presenting as sudden unilateral loss of vision in a human immunodeficiency virus-negative elderly man. METHODS: Clinical case report and literature review. RESULTS: An 84-year-old Chinese man with diabetes mellitus and primary open-angle glaucoma was seen in consultation by our uveitis service for evaluation of sudden vision loss in the right eye...
September 20, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28923584/seeing-the-difference-painless-progressive-vision-loss-in-a-vasculopath
#11
Jenny L Lauschke, Katherine Masselos, Jennifer Sandbach, Clare L Fraser
A 78-year-old Caucasian man with significant vascular disease reported sudden onset of worsened vision during a routine wound-care appointment for non-healing necrotic leg ulcers. He described painless blurring of vision with grey scotomas in his RE, his only well-seeing eye, following trauma to the LE as a child. He presented with retinal ischemia, a cotton-wool spot and optic nerve swelling. Temporal artery biopsy showed myxoid degeneration and extensive calcium deposition which also was shown on imaging throughout his carotid and vertebral arterial system, the clinical picture of calciphylaxis...
September 15, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28916549/positron-emission-tomography-computerized-tomography-in-newly-diagnosed-patients-with-giant-cell-arteritis-who-are-taking-glucocorticoids
#12
Alison H Clifford, Elana M Murphy, Steven C Burrell, Mathew P Bligh, Ryan F MacDougall, J Godfrey Heathcote, Mathieu C Castonguay, Min S Lee, Kara Matheson, John G Hanly
OBJECTIVE: Large vessel uptake on positron emission tomography/computerized tomography (PET/CT) supports the diagnosis of giant cell arteritis (GCA). Its value, however, in patients without arteritis on temporal artery biopsy and in those receiving glucocorticoids remains unknown. We compared PET/CT results in GCA patients with positive (TAB+) and negative temporal artery biopsies (TAB-), and controls. METHODS: Patients with new clinically diagnosed GCA starting treatment with glucocorticoids underwent temporal artery biopsy and PET/CT...
September 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28877848/temporal-artery-biopsy-in-the-diagnosis-of-giant-cell-arteritis-bigger-is-not-always-better
#13
Marios Papadakis, Sarantos Kaptanis, Aikaterini Kokkori-Steinbrecher, Nikolaos Floros, Frauke Schuster, Gunnar Hübner
OBJECTIVE: Accurate early giant cell arteritis (GCA) diagnosis can be established through temporal artery biopsy (TAB). We herein investigate the relationship between specimen length and positive TAB result in a tertiary-care hospital in Germany during a 8-year period. Secondarily, we studied the relationships of specific epidemiological and laboratory parameters with positive TABs. METHOD: We retrospectively reviewed the medical records of all patients with suspected GCA, who underwent TAB in our institution...
September 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28810043/amalric-triangular-syndrome-associated-with-outer-nuclear-layer-infarction
#14
Sean T Garrity, Eric J Holz, David Sarraf
An 85-year-old man presented with temporal headache and bilateral paracentral scotomas. Clinical examination, laboratory testing, and temporal artery biopsy confirmed the diagnosis of giant cell arteritis. Fluorescein angiography illustrated Amalric triangular choroidal infarction of the left eye. Spectral-domain optical coherence tomography of the left eye demonstrated outer nuclear layer abnormalities adjacent to the choroidal infarct. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:668-670.].
August 1, 2017: Ophthalmic Surgery, Lasers & Imaging Retina
https://www.readbyqxmd.com/read/28799318/giant-cell-arteritis-presenting-as-puo
#15
Sham Santhanam, Sampath Kumar Mani
Giant cell arteritis(GCA) is a primary granulomatous vasculitis affecting the large and medium sized arteries. We present here a case of GCA with pyrexia of unknown origin (PUO) as the presenting manifestation in the absence of other typical features. On evaluation, the patient had raised inflammatory markers with features of large vessel vasculitis on whole body PET-CT scan. The colour doppler ultrasonography(CDUS) of the temporal arteries showed bilateral halo sign. Since bilateral 'halo sign' is more specific for the diagnosis of GCA, temporal artery biopsy is not mandatory...
August 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28758156/varicella-zoster-virus-and-large-vessel-vasculitis-the-absence-of-an-association
#16
Gary W Procop, Charis Eng, Alison Clifford, Alexandra Villa-Forte, Leonard H Calabrese, Eric Roselli, Lars Svensson, Douglas Johnston, Gosta Pettersson, Edward Soltesz, Lisa Lystad, Julian D Perry, Alexander Blandford, Deborah A Wilson, Gary S Hoffman
OBJECTIVE: It is controversial whether microorganisms play a role in the pathogenesis of large and medium vessel vasculitides (eg, giant cell arteritis [GCA], Takayasu arteritis [TAK] and focal idiopathic aortitis [FIA]). Recent studies have reported the presence of Varicella Zoster Virus (VZV) within formalin-fixed, paraffin-embedded temporal arteries and aortas of about three-quarters or more of patients with these conditions, and in a minority of controls. In a prospective study, we sought to confirm these findings using DNA extracted from vessels that were harvested under surgically aseptic conditions and snap frozen...
2017: Pathogens & Immunity
https://www.readbyqxmd.com/read/28747747/involvement-of-monocyte-subsets-in-the-immunopathology-of-giant-cell-arteritis
#17
Yannick van Sleen, Qi Wang, Kornelis S M van der Geest, Johanna Westra, Wayel H Abdulahad, Peter Heeringa, Annemieke M H Boots, Elisabeth Brouwer
Monocytes/macrophages are critical in systemic and local inflammation in giant cell arteritis (GCA) and possibly in clinically overlapping polymyalgia rheumatica (PMR). Therefore, we aimed to understand the contribution of monocyte subsets and the CX3CR1-CX3CL1 and CCR2-CCL2 migratory pathways, to the pathology of GCA. Peripheral blood monocytes were enumerated in samples from newly-diagnosed, untreated GCA and PMR patients and after prednisone-induced remission. The distribution of classical (CD14(bright)CD16(neg)) and the more pro-inflammatory, intermediate (CD14(bright)CD16+) and non-classical (CD14(dim)CD16+) monocyte subsets was analysed by flow cytometry...
July 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28712642/febrile-abdominal-pain-revealing-horton-s-disease
#18
Arnaud Chaudet, Jean-Michel Goujon, Aiham Daniel Ghazali
BACKGROUND: Horton's disease is a systemic inflammatory vasculitis, usually found in persons over 50years old. It affects medium and large-sized arteries stemming from the external carotid, especially the superficial temporal arteries. It can affect extracranial large vessels but only rarely the aorta. Diagnosis of aortitis is difficult and its incidence is probably underestimated. CASE PRESENTATION: A 68-year-old Caucasian woman consulted in an emergency department for febrile abdominal pain with inflammatory syndrome...
October 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28675180/temporal-artery-biopsies-in-south-east-scotland-a-five-year-review
#19
S Gajree, S Borooah, N Dhillon, C Goudie, C Smith, P Aspinall, B Dhillon
Temporal artery biopsy is the gold standard investigation for the diagnosis of giant cell arteritis. The aim of this retrospective study was to investigate the use of temporal artery biopsy in diagnosing giant cell arteritis in south-east Scotland over a five-year period. We aimed to quantify success rates, and predictive factors for a positive biopsy, as well as compare the different specialities performing the biopsies. The data should enable the development of better criteria for referral for investigation of giant cell arteritis...
June 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28663795/temporal-artery-biopsy-in-the-diagnosis-of-giant-cell-arteritis-does-the-end-justify-the-means
#20
K Bowling, J Rait, J Atkinson, G Srinivas
BACKGROUND: Early temporal artery biopsy is recommended in all patients with suspected cranial GCA (Giant Cell Arteritis) by the BSR (British Society of Rheumatology) and BHPR (British Health Professionals in Rheumatology) guidelines. This should be performed within one week ideally. AIM: To assess ACR (American College of Rheumatology) score at presentation and whether temporal artery biopsy result affects clinical management of the clinically suspected GCA patient...
August 2017: Annals of Medicine and Surgery
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