Effect of prior steroid treatment on temporal artery biopsy findings in giant cell arteritis

Giant Cell Arteritis

“…However, the efficacy of this regimen is controversial, and steroids typically do not reverse established visual loss (Chan et al 2001). Treatment for possible GCA should be initiated while awaiting temporal artery biopsy because histopathologic evidence of arteritis, if present, persists for several weeks despite CS therapy (Achkar et al 1994;Ray-Chaudhuri et al 2002). The initial oral prednisone dose should be maintained for 4 weeks, and then tapered by about 10% every 2-4 weeks depending on clinical evaluation and levels of inflammatory markers.…”

Riesenzellarteriitis

“…Nach ein-oder mehrwöchiger Steroidtherapie kann es zu Veränderungen der Gefäßwand kommen, die als abgeheilte Riesenzellarteriitis beschrieben wurden [1,19,23]. In solchen Fällen überwiegt ein diffuses und oft nur schüt-teres lymphozytäres und epitheloidzelliges Entzündungszellinfiltrat, wohingegen die charakteristischen Riesenzellen und auch neutrophile Granulozyten deutlich seltener angetroffen werden [1].…”

Ultrasonography in Diagnosis and Follow-Up of Temporal Arteritis: An Update

“…At present, segments of at least 2.5 cm are considered adequate to reduce -but not to completely avoid -the risk of skip lesions (Gonzalez-Gay, 2005). Since histology can be influenced by corticosteroids, TAB should be performed before www.intechopen.com starting therapy (Ray-Chaudhuri et al, 2002) but in most cases it is too hazardous to wait until biopsy is performed, thus steroids are usually started as soon as GCA is clinically suspected (Borg & Dasgupta, 2009). After starting high dose of corticosteroids, TAB can remain informative even for up to 4-6 weeks (Achkar et al, 1994;Ray-Chaudhuri et al, 2002) but it should be performed no later than two weeks ( Borg & Dasgupta, 2009;Warrington & Matteson, 2007).…”