Giant Cell Arteritis: Practical Pearls and Updates

Pradeep, Swati; Smith, Jonathan H.

doi:10.1007/s11916-018-0655-y

Cited by 16 publications

(12 citation statements)

References 74 publications

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“…The role of age in the pathogenesis of GCA has been linked to age-related degenerative changes [ 16 , 23 •], oxidative damage, protein abnormalities, mutations, mitochondrial defect, and age-related vascular inflammation [ 16 , 24 ]. A possible role of sex hormones in the pathophysiology of GCA explains the female predilection [ 17 , 25 ]. The role of infections has been proposed in the pathogenesis of GCA [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Giant Cell Arteritis: A Case-Based Narrative Review of the Literature

Thomas

Pillai

et al. 2022

Curr Pain Headache Rep

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Purpose of Review Giant cell arteritis (GCA) is a chronic, inflammatory condition, primarily affecting the medium and larger arteries. The purpose of this narrative review is to describe GCA in the context of headache and facial pain, based on a case and the available current literature. Understanding the etiology, pathophysiology, the associated conditions, and the differential diagnoses is important in managing GCA. Recent Findings In a patient presenting with unilateral facial/head pain with disturbances of vision, GCA should be considered in the differential diagnosis. There is an association of GCA with several comorbid conditions, and infections including coronavirus-19 (COVID-19) infection. Management of GCA primarily depends upon the identification of the affected artery and prompt treatment. Permanent visual loss and other serious complications are associated with GCA. Summary GCA is characterized by robust inflammation of large- and medium-sized arteries and marked elevation of systemic mediators of inflammation. An interdisciplinary approach of management involving the pertinent specialties is strongly recommended.

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Section: Discussionmentioning

confidence: 99%

Giant Cell Arteritis: A Case-Based Narrative Review of the Literature

Thomas

Pillai

et al. 2022

Curr Pain Headache Rep

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“…Patients with GCA have a wide range of symptoms and clinical ndings related to the involved arteries [4,5]. Headache, temporary and permanent vision loss, jaw claudication, scalp tenderness, and polymyalgia rheumatica are common symptoms [1,[5][6][7]. There may also be general complaints such as fatigue, fever and weight loss [1,5].…”

Section: Introductionmentioning

confidence: 99%

“…Headache, temporary and permanent vision loss, jaw claudication, scalp tenderness, and polymyalgia rheumatica are common symptoms [1,[5][6][7]. There may also be general complaints such as fatigue, fever and weight loss [1,5]. Visual symptoms and signs may include unilateral or bilateral partial or complete vision loss, diplopia, amaurosis fugax, ischemic optic neuritis, and optic atrophy [1].…”

Section: Introductionmentioning

confidence: 99%

Giant Cell (Temporal) Arteritis: The Rate and Clinical Predictors of Histopathological Diagnosis

Yücel

Gün

et al. 2021

Preprint

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Purpose To determine the rate of histopathological diagnosis by temporal artery (TA) biopsy (TAB) and the predictive clinical features of TAB positivity in patients with giant cell arteritis (GCA). Methods The records of patients who underwent TAB with pre-diagnosis of GCA between January 2006 and May 2020 were retrospectively reviewed. The demographic characteristics, symptoms, clinical and laboratory findings, TAB data, and the medications of the patients were recorded. The patients were divided into two groups as TAB-negative and TAB-positive, and compared clinically. Factors affecting TAB positivity were determined. Results TAB confirmed the diagnosis of GCA in 48% of our cases. The median fixed TAB specimen length was 1.7 (0.5–4.0) mm. TAB positivity increased with age (74 vs. 66 years, p = 0.027) and was more common in women (91.7% vs. 38.5%, p = 0.019). Jaw claudication (66.7% vs. 15.4%, p = 0.027) and decreased pulse of the TA (58.3% vs. 7.7%, p = 0.022) were more in the TAB-positive group than in the TAB-negative. The median C-reactive protein (CRP) level was statistically higher in the TAB-positive group compared to the TAB-negative (37 mg/L vs. 12.6 mg/L, p = 0.039). The univariate logistic regression analysis revealed female gender [OR (95%CI): 2.9 (1.7-181.3), p = 0.016], presence of jaw claudication [OR (95%CI): 2.4 (1.6–75.5), p = 0.015], decreased TA pulse [OR (95%CI): 2.8 (1.6-174.5), p = 0.018], and erythrocyte sedimentation rate (ESR) [OR (95%CI): 0.03 (1.0-1.1), p = 0.049] as factors associated with TAB positivity. Conclusion The rate of TAB positivity was 48%. Older age, female gender, the presence of jaw claudication and decreased pulse of TA, high ESR and CRP values are predictive features of TAB positivity and GCA diagnosis.

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“…Giant cell arteritis (GCA) is a non-necrotizing granulomatous vasculitis affecting large and middle-sized arteries. Histologic changes, mainly inflammatory infiltrates with the presence of multinucleated giant cells between the media and intima layers and disruption of the internal elastic lamina, ultimately leads to partial or complete obstruction of local arterial blood flow with the corresponding clinical manifestations of ischemia [1–6]. Branches of the aortic arch are most often affected.…”

Section: Introductionmentioning

confidence: 99%

“…Glucocorticoids are the cornerstone of treatment [2–6]. Some adjuvant therapies, such as methotrexate, have been used as glucocorticoid-sparing agents, thus minimizing their adverse effects, with conflicting results in terms of safety and clinical benefit [28].…”

Section: Introductionmentioning

confidence: 99%

Giant cell arteritis: is the clinical spectrum of the disease changing?

González-Gay

Ortego-Jurado²,

Ercole

et al. 2019

BMC Geriatr

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Background Giant cell arteritis is a vasculitis of large and middle-sized arteries that affects patients aged over 50 years. It can show a typical clinical picture consisting of cranial manifestations but sometimes nonspecific symptoms and large-vessel involvement prevail. Prompt diagnosis and treatment is essential to avoid irreversible damage. Discussion There has been an increasing knowledge on the occurrence of the disease without the typical cranial symptoms and its close relationship and overlap with polymyalgia rheumatica, and this may contribute to reduce the number of underdiagnosed patients. Although temporal artery biopsy is still the gold-standard and temporal artery ultrasonography is being widely used, newer imaging techniques (FDG-PET/TAC, MRI, CT) can be of valuable help to identify giant cell arteritis, in particular in those cases with a predominance of extracranial large-vessel manifestations. Conclusions Giant cell arteritis is a more heterogeneous condition than previously thought. Awareness of all the potential clinical manifestations and judicious use of diagnostic tests may be an aid to avoid delayed detection and consequently ominous complications.

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Giant Cell Arteritis: Practical Pearls and Updates

Cited by 16 publications

References 74 publications

Giant Cell Arteritis: A Case-Based Narrative Review of the Literature

Giant Cell Arteritis: A Case-Based Narrative Review of the Literature

Giant Cell (Temporal) Arteritis: The Rate and Clinical Predictors of Histopathological Diagnosis

Giant cell arteritis: is the clinical spectrum of the disease changing?

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