Ultrasonido Doppler de arterias temporales en pacientes con arteritis de células gigantes: estado del arte y revisión sistemática de la literatura

Temporal superficial arteritis as differential diagnosis in patients with atherosclerotic changes due to advanced chronic renal disease: case report and review of the literature

“…On the other hand, Aschwanden et al., in another noncontrolled prospective cohort study in 2015, found that the noncompressibility sign had a sensitivity of 79% and a specificity of 100%. This shows that the use of imaging-based diagnosis is supported in the literature, although the interpretation and any potential limitations of Doppler ultrasound depend on the technique and the expertise of the radiologist in identifying the findings [4] .…”

“…It occurs more frequently in white women (2:1 F:M ratio) and in individuals over 50 years of age. It is the most common systemic vasculitis of the granulomatous type with chronic presentation; the annual incidence varies between 1.6 and 32.8 cases × 100,00 inhabitants in Europe, USA, Israel, and Oceania; epidemiological data for Colombia are nonavailable [4] . The triggering agent for this autoimmune disease occurring in patients with predisposing factors and HLA class II polymorphisms is unknown [8] .…”

“…The triggering agent for this autoimmune disease occurring in patients with predisposing factors and HLA class II polymorphisms is unknown [8] . Histologically, there is vascular infiltration of CD4+ T cells and macrophages that fuse to form “giant cells” that are deposited on the vessel wall, leading to arterial intimal hyperplasia and thickening, reduced blood flow due to stenosis, and arterial occlusion, and giving rise to the typical symptomatology of this disease [ 2 , 4 ].

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“…The most frequent with severe manifestations and more prevalent in the elderly population is the cranial presentation characterized by headache, predominantly temporal in 70%-80%, with scalp hypersensitivity and mandibular claudication; it can even trigger visual loss secondary to ischemic optic neuritis. On the other hand, the extracranial phenotype, also called giant cell arteritis, affects younger patients and involves the aorta and its proximal branches, the main associated symptoms being fever, upper limb claudication, aortitis, and constitutional symptoms such as weight loss, asthenia and myalgia [ 4 , 6 ].…”

“…Other potential etiologies such as calcifications found in chronic renal disease cannot be ruled out. However, so far there is no consensus to allow the appropriate distinction between vessel wall inflammation and atherosclerotic changes [4] .…”