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vasculite geral

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https://www.readbyqxmd.com/read/28460064/the-use-of-ultrasound-to-assess-giant-cell-arteritis-review-of-the-current-evidence-and-practical-guide-for-the-rheumatologist
#1
Sara Monti, Alberto Floris, Cristina Ponte, Wolfgang A Schmidt, Andreas P Diamantopoulos, Claudio Pereira, Jennifer Piper, Raashid Luqmani
Colour duplex sonography (CDS) of temporal arteries and large vessels is an emerging diagnostic tool for GCA. CDS can detect wall oedema, known as a halo, throughout the length of the vessel and shows higher sensitivity compared with biopsy. Specificity reaches 100% in case of bilateral halos. A positive compression sign has been demonstrated to be a robust marker with excellent inter-observer agreement. The assessment of other large vessels, particularly the axillary arteries, is recognized to further increase the sensitivity and to reliably represent extra-cranial involvement in other areas...
April 27, 2017: Rheumatology
https://www.readbyqxmd.com/read/28375833/clinical-assessment-in-takayasu-s-arteritis-major-challenges-and-controversies
#2
REVIEW
Haner Direskeneli
Takayasu's arteritis (TAK) is a rare, chronic, large-vessel vasculitis (LVV) that predominantly affects aorta, its major branches and the pulmonary arteries. Recent controversial issues in the diagnosis, disease assessment and prognosis in TAK are discussed in this review. In recent years, conventional angiography, the standard method for the initial diagnosis, seems to have been replaced by the new imaging modalities, such as MRI and 18F-FDG-PET. Less invasive techniques (CT/MRI) are now suggested first, compared to conventional angiography, and MRI is preferable to CT with less contrast load/radiation...
March 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
#3
REVIEW
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 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28466806/hcv-unrelated-cryoglobulinaemic-vasculitis-the-results-of-a-prospective-observational-study-by-the-italian-group-for-the-study-of-cryoglobulinaemias-gisc
#4
MULTICENTER STUDY
Massimo Galli, Letizia Oreni, Francesco Saccardo, Laura Castelnovo, Davide Filippini, Piero Marson, Maria Teresa Mascia, Cesare Mazzaro, Laura Origgi, Elena Ossi, Maurizio Pietrogrande, Piero Pioltelli, Luca Quartuccio, Salvatore Scarpato, Salvatore Sollima, Agostino Riva, Paolo Fraticelli, Roberta Zani, Dilia Giuggioli, Marco Sebastiani, Piercarlo Sarzi Puttini, Armando Gabrielli, Anna Linda Zignego, Patrizia Scaini, Clodoveo Ferri, Salvatore De Vita, Giuseppe Monti
OBJECTIVES: To investigate the clinical and laboratory patterns of HCV-unrelated cryoglobulinaemic vasculitis (CV), and the factors influencing its outcome. METHODS: Prospective study of all anti-HCV and HCV-RNA negative patients with CV who have been observed since January 2004 in 17 centres participating in the Italian Group for the Study of Cryoglobulinaemias (GISC). RESULTS: 175 enrolled were followed up for 677 person-years. The associated conditions were primary Sjögren's syndrome (21...
March 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28479485/new-insights-into-the-pathogenesis-of-giant-cell-arteritis
#5
REVIEW
Francesco Ciccia, Aroldo Rizzo, Angelo Ferrante, Giuliana Guggino, Stefania Croci, Alberto Cavazza, Carlo Salvarani, Giovanni Triolo
Giant cell arteritis (GCA) is an inflammatory chronic disease occurring exclusively in elderly individuals. Until recently, the disease has been considered a unique disease resulting from the interaction in the walls of susceptible arteries, between an unknown infectious agents with local dendritic cells (DCs), activated CD4 T cells and effector macrophages. Recent evidence has shown that this view was too simplistic and has clarified many of the pathogenetic aspects of the disease. Many genetic studies recently published have identified different new genes, including cytokines, adhesion molecules and regulators of innate immunity, as crucial players in the development and progression of GCA...
July 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28780080/-how-i-treat-autoimmune-diseases-state-of-the-art-on-the-management-of-rare-rheumatic-diseases-and-anca-associated-systemic-idiopathic-vasculitis
#6
EDITORIAL
Dario Roccatello
This Special Issue of Autoimmunity Reviews constitutes summaries of presentations at the 20th International Meeting on Immunopathology and Orphan Diseases, held in Torino, Italy, 25-28th January 2017. As such, these presentations represent the state of the art on the pathophysiology of autoimmune diseases as well as the most recent insights into the management of these pathologic conditions. The latter includes both the optimal use of established drugs and approaches as well as novel knowledge on the means and consequences of targeted blocking of molecules or cellular mechanisms...
August 2, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/27684357/systemic-vasculitis-and-the-gut
#7
REVIEW
Ibrahim Hatemi, Gulen Hatemi, Aykut F Çelik
PURPOSE OF REVIEW: Gastrointestinal system can be involved in primary and secondary vasculitides. The recent data regarding the pathophysiology, clinical findings, diagnosis, management, and outcome of gastrointestinal involvement in different types of vasculitis are reviewed. RECENT FINDINGS: Diagnosis of gastrointestinal vasculitis may be difficult and relies mostly on imaging, because biopsy samples are hard to obtain and superficial mucosal biopsies have a low yield...
January 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28745999/trial-of-tocilizumab-in-giant-cell-arteritis
#8
RANDOMIZED CONTROLLED TRIAL
John H Stone, Katie Tuckwell, Sophie Dimonaco, Micki Klearman, Martin Aringer, Daniel Blockmans, Elisabeth Brouwer, Maria C Cid, Bhaskar Dasgupta, Juergen Rech, Carlo Salvarani, Georg Schett, Hendrik Schulze-Koops, Robert Spiera, Sebastian H Unizony, Neil Collinson
BACKGROUND: Giant-cell arteritis commonly relapses when glucocorticoids are tapered, and the prolonged use of glucocorticoids is associated with side effects. The effect of the interleukin-6 receptor alpha inhibitor tocilizumab on the rates of relapse during glucocorticoid tapering was studied in patients with giant-cell arteritis. METHODS: In this 1-year trial, we randomly assigned 251 patients, in a 2:1:1:1 ratio, to receive subcutaneous tocilizumab (at a dose of 162 mg) weekly or every other week, combined with a 26-week prednisone taper, or placebo combined with a prednisone taper over a period of either 26 weeks or 52 weeks...
July 27, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28680132/visual-loss-and-other-cranial-ischaemic-complications-in-giant-cell-arteritis
#9
REVIEW
Alessandra Soriano, Francesco Muratore, Nicolò Pipitone, Luigi Boiardi, Luca Cimino, Carlo Salvarani
Giant cell arteritis (GCA) is the most common form of vasculitis in individuals aged 50 years and over. GCA typically affects large and medium-sized arteries, with a predilection for the extracranial branches of the carotid artery. Patients with GCA usually present with symptoms and signs that are directly related to the artery that is affected, with or without constitutional manifestations. The most dreaded complication of GCA is visual loss, which affects about one in six patients and is typically caused by arteritis of the ophthalmic branches of the internal carotid artery...
August 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28460395/polymyalgia-rheumatica
#10
REVIEW
Eric L Matteson, Christian Dejaco
This issue provides a clinical overview of polymyalgia rheumatica, focusing on risk factors, diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers...
May 2, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28605168/characteristics-and-management-of-iga-vasculitis-henoch-sch%C3%A3-nlein-in-adults-data-from-260-patients-included-in-a-french-multicenter-retrospective-survey
#11
MULTICENTER STUDY
Alexandra Audemard-Verger, Benjamin Terrier, Agnès Dechartres, Johan Chanal, Zahir Amoura, Noémie Le Gouellec, Patrice Cacoub, Noémie Jourde-Chiche, Geoffrey Urbanski, Jean-François Augusto, Guillaume Moulis, Loic Raffray, Alban Deroux, Aurélie Hummel, Bertrand Lioger, Mélanie Catroux, Stanislas Faguer, Julie Goutte, Nihal Martis, François Maurier, Etienne Rivière, Sébastien Sanges, Aurélie Baldolli, Nathalie Costedoat-Chalumeau, Mélanie Roriz, Xavier Puéchal, Marc André, Christian Lavigne, Boris Bienvenu, Arsène Mekinian, Elie Zagdoun, Charlotte Girard, Alice Bérezné, Loïc Guillevin, Eric Thervet, Evangéline Pillebout
OBJECTIVE: Data on adult IgA vasculitis (Henoch-Schönlein) (IgAV) are scarce. This survey was designed to better define the clinical spectrum of IgAV and efficacy of treatments in a French patient population. METHODS: Data on clinical characteristics, histologic features, and treatment response from 260 patients with IgAV included in a French multicenter retrospective survey were analyzed. Efficacy data were compared using different statistical models. RESULTS: The mean ± SD age of the patients with IgAV at diagnosis was 50...
September 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28133925/a-randomized-double-blind-trial-of-abatacept-ctla-4ig-for-the-treatment-of-giant-cell-arteritis
#12
RANDOMIZED CONTROLLED TRIAL
Carol A Langford, David Cuthbertson, Steven R Ytterberg, Nader Khalidi, Paul A Monach, Simon Carette, Philip Seo, Larry W Moreland, Michael Weisman, Curry L Koening, Antoine G Sreih, Robert Spiera, Carol A McAlear, Kenneth J Warrington, Christian Pagnoux, Kathleen McKinnon, Lindsy J Forbess, Gary S Hoffman, Renée Borchin, Jeffrey P Krischer, Peter A Merkel
OBJECTIVE: To compare the efficacy of abatacept to that of placebo for the treatment of giant cell arteritis (GCA). METHODS: In this multicenter trial, patients with newly diagnosed or relapsing GCA were treated with abatacept 10 mg/kg intravenously on days 1, 15, and 29 and week 8, together with prednisone administered daily. At week 12, patients in remission underwent a double-blinded randomization to continue to receive abatacept monthly or switch to placebo...
April 2017: Arthritis & Rheumatology
https://www.readbyqxmd.com/read/28595278/takayasu-arteritis-active-or-not-that-s-the-question
#13
Alexander Dikkes, Markus Aschwanden, Stephan Imfeld, Katharina Glatz, Juerg Messerli, Daniel Staub, Thomas Daikeler
No abstract text is available yet for this article.
June 7, 2017: Rheumatology
https://www.readbyqxmd.com/read/28490787/the-changing-face-of-polyarteritis-nodosa-and-necrotizing-vasculitis
#14
REVIEW
Seza Ozen
Polyarteritis nodosa (PAN) is a vasculitic disease characterized primarily by necrotizing vasculitis - inflammatory lesions in blood vessels that lead to vessel wall necrosis. Our understanding of PAN and necrotizing vasculitis has evolved over time. In addition to PAN, necrotizing vasculitis is now a recognized feature of a broad range of diseases with different aetiopathogenesis. For example, necrotizing vasculitis associated with hepatitis B virus infection has a different aetiopathogeneis to PAN and is now classified as a separate disease...
June 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28356445/diagnosis-treatment-and-long-term-management-of-kawasaki-disease-a-scientific-statement-for-health-professionals-from-the-american-heart-association
#15
REVIEW
Brian W McCrindle, Anne H Rowley, Jane W Newburger, Jane C Burns, Anne F Bolger, Michael Gewitz, Annette L Baker, Mary Anne Jackson, Masato Takahashi, Pinak B Shah, Tohru Kobayashi, Mei-Hwan Wu, Tsutomu T Saji, Elfriede Pahl
BACKGROUND: Kawasaki disease is an acute vasculitis of childhood that leads to coronary artery aneurysms in ≈25% of untreated cases. It has been reported worldwide and is the leading cause of acquired heart disease in children in developed countries. METHODS AND RESULTS: To revise the previous American Heart Association guidelines, a multidisciplinary writing group of experts was convened to review and appraise available evidence and practice-based opinion, as well as to provide updated recommendations for diagnosis, treatment of the acute illness, and long-term management...
April 25, 2017: Circulation
https://www.readbyqxmd.com/read/28286108/international-therapeutic-guidelines-for-patients-with-hcv-related-extrahepatic-disorders-a-multidisciplinary-expert-statement
#16
REVIEW
Anna Linda Zignego, Manuel Ramos-Casals, Clodoveo Ferri, David Saadoun, Luca Arcaini, Dario Roccatello, Alessandro Antonelli, Anne Claire Desbois, Cloe Comarmond, Laura Gragnani, Milvia Casato, Peter Lamprecht, Alessandra Mangia, Athanasios G Tzioufas, Zobair M Younossi, Patrice Cacoub
Hepatitis C virus (HCV) is both hepatotrophic and lymphotropic virus that causes liver as well extrahepatic manifestations including cryoglobulinemic vasculitis, the most frequent and studied condition, lymphoma, and neurologic, cardiovascular, endocrine-metabolic or renal diseases. HCV-extrahepatic manifestations (HCV-EHMs) may severely affect the overall prognosis, while viral eradication significantly reduces non-liver related deaths. Different clinical manifestations may coexist in the same patient. Due to the variety of HCV clinical manifestations, a multidisciplinary approach along with appropriate therapeutic strategies are required...
May 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28340158/maintenance-therapy-is-associated-with-better-long-term-outcomes-in-adult-patients-with-primary-angiitis-of-the-central-nervous-system
#17
Hubert de Boysson, Jean-Jacques Parienti, Caroline Arquizan, Grégoire Boulouis, Nicolas Gaillard, Alexis Régent, Antoine Néel, Olivier Detante, Emanuel Touzé, Achille Aouba, Boris Bienvenu, Loïc Guillevin, Olivier Naggara, Mathieu Zuber, Christian Pagnoux
Objective.: We aimed to analyse the effect of maintenance therapy after induction on the outcomes of adult patients with primary angiitis of the CNS (PACNS). Methods.: We analysed long-term outcomes (relapse, survival and functional status) of patients enrolled in the French multicentre PACNS cohort who achieved remission after induction treatment and with ⩾12 months' follow-up, according to whether or not they received maintenance therapy. Good outcome was defined as relapse-free survival and good functional status (modified Rankin scale ⩽ 2) at last follow-up...
March 17, 2017: Rheumatology
https://www.readbyqxmd.com/read/28244857/diagnostic-validity-of-doppler-ultrasound-in-giant-cell-arteritis
#18
COMPARATIVE STUDY
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...
March 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28137481/characterization-of-isolated-retinal-vasculitis-analysis-of-a-cohort-from-a-single-center-and-literature-review
#19
REVIEW
Laura Pelegrín, José Hernández-Rodríguez, Gerard Espinosa, Víctor Llorenç, Maite Sainz-de-la-Maza, José R Fontenla, José A Martínez, Maria C Cid, Alfredo Adán
INTRODUCTION: Isolated retinal vasculitis (IRV) is an inflammatory condition of unknown etiology confined to the retinal vessels. In contrast to secondary retinal vasculitis (RV), IRV has not been well characterized. OBJECTIVE: To describe and characterize isolated forms of RV. METHODS: We performed a retrospective review (2006-2016) of IRV patients from a multidisciplinary Uveitis Unit. RV diagnosis was based on funduscopic and fluorescein angiography findings...
March 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28137477/inflammatory-eye-disease-pre-treatment-assessment-of-patients-prior-to-commencing-immunosuppressive-and-biologic-therapy-recommendations-from-an-expert-committee
#20
REVIEW
Denis Wakefield, Peter McCluskey, Gerhild Wildner, Stephan Thurau, Gregory Carr, Soon-Phaik Chee, John Forrester, Andrew Dick, Bernard Hudson, Susan Lightman, Justine Smith, Ilknur Tugal-Tutkun
AIM: To outline recommendations from an expert committee on the assessment and investigation of patients with severe inflammatory eye disease commencing immunosuppressive and/or biologic therapy. METHOD: The approach to assessment is based on the clinical experience of an expert committee and a review of the literature with regard to corticosteroids, immunosuppressive drug and biologic therapy and other adjunct therapy in the management of patients with severe sight-threatening inflammatory eye disease...
March 2017: Autoimmunity Reviews
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