Analysis of Varicella-Zoster Virus in Temporal Arteries Biopsy Positive and Negative for Giant Cell Arteritis

Nagel, Maria A.; White, Teresa; Khmeleva, Nelly; Rempel, April; Boyer, Philip J.; Bennett, Jeffrey L.; Haller, Andrea; Lear-Kaul, Kelly C.; Kandasmy, Balasurbramaniyam; Amato, Malena; Wood, Edward H.; Durairaj, Vikram D.; Fogt, Franz; Tamhankar, Madhura A.; Grossniklaus, Hans E.; Poppiti, Robert; Bockelman, Brian; Keyvani, Kathy; Pollak, Lea; Mendlovic, Sonia; Fowkes, Mary; Eberhart, Charles G.; Buttmann, Mathias; Toyka, Klaus V.; Meyer-ter-Vehn, Tobias; Pétursdóttir, Vigdís; Gilden, Don

doi:10.1001/jamaneurol.2015.2101

Cited by 100 publications

(68 citation statements)

References 10 publications

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“…Rigorous studies, however, failed in demonstrating a unique or dominant role of these infectious agents. Recently, an association of GCA with varicella zoster virus (VZV) has been documented [18]. VZV is a human neurotropic alpha herpes virus that is able to replicate in arteries causing disease [19].…”

Section: Role Of Infectious Agentsmentioning

confidence: 99%

“…VZV vasculopathy causes ischaemic infarction of the brain and spinal cord, as well as aneurysm, subarachnoid and cerebral haemorrhage, and carotid dissection [19]. In GCA patients VZV antigen has been found in the 64% of GCA-negative temporal arteries (TAs) and in the 73% of GCA-positive TAs, compared with 22% of normal TAs with a relative risk [RR]of 2.86 [18]. VZV antigen was more likely to be present in the adventitia of both GCA-negative TAs (RR = 2.43) and GCA-positive TAs (RR = 2.03).…”

Section: Role Of Infectious Agentsmentioning

confidence: 99%

See 1 more Smart Citation

New insights into the pathogenesis of giant cell arteritis

Ciccia

Rizzo

Ferrante

et al. 2017

Autoimmunity Reviews

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Section: Role Of Infectious Agentsmentioning

confidence: 99%

Section: Role Of Infectious Agentsmentioning

confidence: 99%

New insights into the pathogenesis of giant cell arteritis

Ciccia

Rizzo

Ferrante

et al. 2017

Autoimmunity Reviews

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“…Typical inflammatory histopathology was detected in 89 % of GCA-positive TAs but not in any of the 18 adjacent tissue sections from normal TAs [32]. A very recent follow-up study by these authors found that VZV antigen was present in 64 % of GCA-negative TAs compared with 22 % of normal TAs [33]. They concluded that in patients with clinically suspected GCA, the prevalence of VZV in their TAs is similar, irrespective of whether the TA biopsy results are negative or positive histopathologically.…”

Section: Giant Cell Arteritismentioning

confidence: 87%

Issues in the Treatment of Neurological Conditions Caused by Reactivation of Varicella Zoster Virus (VZV)

Kennedy

2016

Neurotherapeutics

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Varicella zoster virus (VZV) is a ubiquitous neurotropic human herpesvirus. Primary infection usually causes varicella (chicken pox), after which virus becomes latent in ganglia along the entire neuraxis. Decades later, virus reactivates to produce herpes zoster (shingles), a painful dermatomally distributed vesicular eruption. Zoster may be further complicated by postherpetic neuralgia, VZV vasculopathy, myelitis, and segmental motor weakness. VZV reactivation has also been associated with giant cell arteritis. This overview discusses treatment of various conditions that often require both corticosteroids and antiviral drugs. Treatment for VZV-associated disease is often based on case reports and small studies rather than largescale clinical trials. Issues that require resolution include the optimal duration of such combined therapy, more effective treatment for postherpetic neuralgia, whether some treatments should be given orally or intravenously, the widening spectrum of zoster sine herpete, and the role of antiviral therapy in giant cell arteritis.

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“…The study by Gilden et al [19] has shown the presence of VZV antigen in 74% patients of temporal artery biopsy-proven GCA versus 8% in normal temporal arteries (p<0.0001), while Nagel et al [20] found the proportions to be 64% and 22% respectively (p<0.001). Gilden et al have also found the prevalence of the VZV antigen in patients with a clinical and serological feature of GCA (with or without a positive temporal artery biopsy) in significantly higher numbers compared to those without [19].…”

Section: Vzv Vasculopathy and Giant Cell Arteritismentioning

confidence: 96%

Central Nervous System Vasculopathy In Varicella Zoster Virus Infection

Mehta¹,

Desai²,

Mirtchev³

2017

J Neuroinfect Dis

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Varicella zoster virus is an exclusively human double-stranded DNA virus that is the causative factor for two ubiquitous conditions: varicella in children and zoster in adults. Both conditions are associated with neurological complications. Centripetal trans-axonal spread via cranial nerve ganglia appears to afford entry into the central nervous system. There is increasing evidence of varicella zoster virus playing a role in the development of giant cell arteritis. First associated with transient ischemic attacks and ischemic strokes, vasculopathy secondary to varicella zoster virus infections has now been associated with aneurysms that may or may not lead to subarachnoid hemorrhage, multifocal vasculitis, arterial dissection, dolicoectasia, cortical venous sinus thrombosis, ischemic cranial neuropathies and spinal cord infarction. Prior knowledge of the myriad clinical manifestations helps in early diagnosis and treatment of the complications.

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Analysis of Varicella-Zoster Virus in Temporal Arteries Biopsy Positive and Negative for Giant Cell Arteritis

Cited by 100 publications

References 10 publications

New insights into the pathogenesis of giant cell arteritis

New insights into the pathogenesis of giant cell arteritis

Issues in the Treatment of Neurological Conditions Caused by Reactivation of Varicella Zoster Virus (VZV)

Central Nervous System Vasculopathy In Varicella Zoster Virus Infection

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