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Rheumatology (Oxford) 2021 Jun 23. Epub 2021 Jun 23.

Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.

Objectives: To investigate whether giant cell arteritis (GCA) is associated with increased all-cause and cause-specific mortality.

Methods: A nationwide, population-based cohort study in Denmark using medical and administrative registries. GCA cases were defined as patients aged ≥50 years from 1996-2018 with a first-time discharge diagnosis of GCA and ≥3 prescriptions for prednisolone within 6 months following diagnosis. Read More

Neurohospitalist 2021 Jul 4;11(3):275-276. Epub 2021 Jun 4.

Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.

Swiss Med Wkly 2021 Jun 23;151:w20512. Epub 2021 Jun 23.

Department of Rheumatology, University Hospital Basel, Switzerland.

Aims: To describe the feasibility and diagnostic accuracy of 18F-FDG positron emission tomography-computed tomography (PET/CT) of the temporal artery compared with temporal artery ultrasound and histology of the temporal artery in patients with suspicion of having giant cell arteritis (GCA).

Materials And Methods: Patients with suspected GCA were included. PET/CT standard uptake value ratios and the compression sign on ultrasound were assessed for the trunk, and parietal and frontal branches of the temporal artery. Read More

BMC Neurol 2021 Jun 22;21(1):228. Epub 2021 Jun 22.

Department of Neurology, Otto von Guericke University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.

Backround: We describe one of the first cases of a Posterior reversible encephalopathy syndrome (PRES) under tocilizumab as treatment of Giant cell arteritis (GCA).

Case Presentation: A 65-year-old female with known GCA and treatment with Tocilizumab (TCZ) developed a convulsive epileptic seizure for the first time. MRI was suggestive of PRES and an associated left sided occipital hemorrhage. Read More

Semin Arthritis Rheum 2021 Jun 7;51(4):786-792. Epub 2021 Jun 7.

Rheumatology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy; Università di Modena e Reggio Emilia, Modena, Italy. Electronic address:

Objectives: To investigate the epidemiology of the entire spectrum of large vessel vasculitis (LVV) in a well-defined population from a Northern Italian area.

Methods: All patients with incident giant cell arteritis (GCA) diagnosed from 2005 to 2016 and all patients with incident Takayasu arteritis (TAK) diagnosed from 1998 to 2016 living in the Reggio Emilia area were identified. Only patients satisfying the modified inclusion criteria of the GiACTA trial, and the 1990 ACR classification criteria for TAK were included. Read More

Rev Med Interne 2021 Jun 15. Epub 2021 Jun 15.

Service de médecine interne, Nouvel Hôpital civil, CHU de Strasbourg, Strasbourg, France.

Semin Arthritis Rheum 2021 May 18. Epub 2021 May 18.

Department of Rheumatology, Medical University of Graz, Graz; Austria and Department of Rheumatology, Hospital of Bruneck, Bruneck, Italy.

Objectives: To define chronic ultrasound lesions of the axillary artery (AA) in long-standing giant cell arteritis (GCA) and to evaluate the reliability of the new ultrasound definition in a web-based exercise.

Methods: A structured Delphi, involving an expert panel of the Large Vessel Vasculitis subgroup of the Outcome Measures in Rheumatology (OMERACT) Ultrasound Working Group was carried out. The reliability of the new definition was tested in a 2-round web-based exercise involving 23 experts and using 50 still images each from AA of long-standing and acute GCA patients, as well as 50 images from healthy individuals. Read More

Rheumatology (Oxford) 2021 Jun;60(Supplement_3):iii9-iii11

Vasculitis and Lupus Unit, Department of Medicine, University of Cambridge, Cambridge, UK.

Rheumatology (Oxford) 2021 Jun;60(Supplement_3):iii12-iii14

Department of Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.

GMS Ophthalmol Cases 2021 17;11:Doc10. Epub 2021 May 17.

York General Hospital, Ophthalmology Department, York, United Kingdom.

Nocardiosis is an extremely rare, opportunistic, Gram-positive bacterial infection that has a high mortality rate in those patients who are immunocompromised in the presence of disseminated disease. We describe a case of an elderly lady being treated with high-dose corticosteroids for giant cell arteritis that presented with ischaemic optic atrophy. Subsequent deterioration was accompanied by the development of subretinal lesions. Read More

Med Clin (Barc) 2021 May 27. Epub 2021 May 27.

Unidad de Enfermedades Sistémicas. Servicio de Medicina Interna. Hospital Clínico Universitario San Cecilio, Granada, España.

Rheumatology (Oxford) 2021 Jun 12. Epub 2021 Jun 12.

Department of Rheumatology and Immunology, University of Bern, Inselspital, Switzerland.

Objectives: To characterize the effect of ultra-short glucocorticoids followed by Tocilizumab monotherapy on the intima-media thickness (IMT) in GCA.

Methods: 18 GCA patients received 500mg methylprednisolone intravenously on days 0-2, followed by Tocilizumab (8mg/kg) intravenously on day 3 and thereafter weekly subcutaneous Tocilizumab injections (162 mg) over 52 weeks. Ultrasound of temporal (TA), axillary (AA) and subclavian (SA) arteries was performed at baseline, on days 2-3, at week 4, 8, 12, 24 and 52. Read More

Br Dent J 2021 Jun;230(11):687

By email, Norwich, UK.

Open Access Rheumatol 2021 1;13:153-165. Epub 2021 Jun 1.

Department of General Internal Medicine, University Hospitals Leuven, Leuven, Belgium.

The large vessel vasculitides comprise giant cell arteritis (GCA), Takayasu arteritis (TAK), and chronic periaortitis. The diagnostic approach to these conditions involves the correct use and interpretation of clinical criteria, imaging techniques, and, in case of GCA, temporal artery biopsy. Ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) reveal a homogeneous, concentric, thickening of the arterial wall. Read More

Semergen 2021 May-Jun;47(4):256-266. Epub 2021 Jun 8.

Centro de Salud Comillas, Madrid, España.

Giant cell arteritis is a systemic vasculitis with significant intra and extracranial involvement that, with early diagnosis and treatment in primary care, can improve its prognosis as it is a medical emergency. Our working group on vascular diseases of the Spanish Society of Primary Care Physicians (SEMERGEN) proposes a series of recommendations based on current scientific evidence for a multidisciplinary approach and follow-up in primary care. Read More

Expert Opin Investig Drugs 2021 Jun 9. Epub 2021 Jun 9.

Department of Rheumatology, St. James's Hospital, Dublin, Republic of Ireland.

Introduction: Giant Cell Arteritis (GCA) is the most common systemic vasculitis worldwide. For decades, glucocorticoids have represented the mainstay of treatment, at the expense of toxic systemic effects owing to prolonged courses of high dose treatment regimens. The search for effective drugs permitting lower glucocorticoid treatment regimens in GCA has been a frustrating one. Read More

Arthritis Rheumatol 2021 Jun 8. Epub 2021 Jun 8.

Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Objective: Macrophages mediate inflammation, angiogenesis and tissue destruction in giant cell arteritis (GCA). Serum levels of the macrophage-associated protein YKL-40 (chitinase-3 like-1), previously linked to angiogenesis and tissue remodeling, remain elevated in GCA despite glucocorticoid treatment. Here, we aimed to investigate the contribution of YKL-40 to vasculopathy in GCA. Read More

J Nucl Med 2021 Jun 4. Epub 2021 Jun 4.

National Institute of Arthritis and Musculoskeletal and Skin Diseases, United States.

The study rationale was to assess the performance of qualitative and semi-quantitative scoring methods for F-fluorodeoxyglucose positron emission tomography (FDG-PET) assessment in large-vessel vasculitis (LVV). Patients with giant cell arteritis (GCA) or Takayasu's arteritis (TAK) underwent clinical and imaging assessment, blinded to each other, within a prospective observational cohort. FDG-PET-CT scans were interpreted for active vasculitis by central reader assessment. Read More

Mayo Clin Proc 2021 06;96(6):1530-1545

Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN.

Giant cell arteritis (GCA) is the most common primary systemic vasculitis in adults 50 years or older. Expanded use of advanced arterial imaging has assisted both in the diagnosis of GCA and recognition of disease subsets. Although glucocorticoids have been the mainstay of treatment for almost 7 decades, new therapeutic options have emerged. Read More

Curr Pain Headache Rep 2021 Jun 4;25(8):50. Epub 2021 Jun 4.

Professional Program for International Dentists, University of California Los A ngeles School of Dentistry, Los Angeles, CA, USA.

Purpose Of Review: Mönckeberg's medial sclerosis (MMS) is a chronic, non-inflammatory degenerative condition affecting primarily the tunica media of muscular arteries resulting in their calcification. The purpose of this comprehensive review is to describe MMS as it appears in the literature, in the context of headache and facial pain. Understanding the etiopathology, the associated conditions, and the differential diagnoses is important in managing MMS. Read More

J Rheumatol 2021 Jun 1. Epub 2021 Jun 1.

Vasculitis Clinic, Canadian Network for Research on Vasculitides, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, University of Montreal; Division of Immunology and Allergy, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, University of Montreal, Montreal, Quebec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J.P. Makhzoum, Vasculitis Clinic, Division of Internal Medicine, Department of Medicine, Hôpital du Sacré-Coeur de Montréal, University of Montreal, 5400 Gouin O Blvd., Montreal, QC H4J 1C5, Canada. Email:

VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome was recently discovered in 25 men with late-onset severe and refractory inflammatory syndromes and associated hematologic abnormalities. Various diseases have been described, such as relapsing polychondritis, myelodysplastic syndrome, polyarteritis nodosa, and giant cell arteritis. Read More

J Rheumatol 2021 Jun 1. Epub 2021 Jun 1.

P.M. Villiger, MD, Full Professor of Rheumatology and Clinical Immunology em, University of Bern, Switzerland. PMV receives speaker, advisory fees, and research support from Roche, MSD, AbbVie, Pfizer, Novartis, Grünenthal, Amgen, Sanofi, Chugai, BMS, and Gilead. Address correspondence to Dr. P. Villiger, Medical Center Monbijou, 3011 Bern, Switzerland. Email:

Giant cell arteritis (GCA), the most frequent form of vasculitis in the elderly, still poses questions regarding optimal treatment. Because of the risk of permanent vision loss, the revised European League Against Rheumatism recommendation of 2018 stresses that glucocorticoid (GC) therapy should start as soon as a diagnosis of GCA is strongly suspected.. Read More

Antioxidants (Basel) 2021 May 31;10(6). Epub 2021 May 31.

Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Firenze, 50134 Firenze, Italy.

Giant cell arteritis (GCA), medium and large vessel granulomatous vasculitis affecting the elderly, is characterized by a multitude of vascular complications, including venous thrombosis, myocardial infraction and stroke. The formation of granulomatous infiltrates and the enhanced accumulation of proinflammatory cytokines are typical features of this condition. The GCA pathogenesis remains largely unknown, but recent studies have suggested the involvement of oxidative stress, mainly sustained by an enhanced reactive oxygen species (ROS) production by immature neutrophils. Read More

Biomedicines 2021 May 31;9(6). Epub 2021 May 31.

Kardiologie I and DZHK Standort Rhein-Main, Universitätsmedizin Mainz, 55131 Mainz, Germany.

The term coronary "artery vasculitis" is used for a diverse group of diseases with a wide spectrum of manifestations and severity. Clinical manifestations may include pericarditis or myocarditis due to involvement of the coronary microvasculature, stenosis, aneurysm, or spontaneous dissection of large coronaries, or vascular thrombosis. As compared to common atherosclerosis, patients with coronary artery vasculitis are younger and often have a more rapid disease progression. Read More

Diagnostics (Basel) 2021 May 14;11(5). Epub 2021 May 14.

Department of Ophthalmology, Rigshospitalet, University of Copenhagen, 2600 Glostrup, Denmark.

Giant cell arteritis (GCA) is the most common form of large vessel vasculitis. GCA is a medical and ophthalmological emergency, and rapid diagnosis and treatment with high-dose corticosteroids is critical in order to reduce the risk of stroke and sudden irreversible loss of vision. GCA can be difficult to diagnose due to insidious and unspecific symptoms-especially if typical superficial extracranial arteries are not affected. Read More

Ann Rheum Dis 2021 May 28. Epub 2021 May 28.

Vasculitis and Glomerulonephritis Center, Rheumatology, Immunology and Allergy Division, Massachusetts General Hospital, Boston, Massachusetts, USA

Objective: Identify predictors of treatment failure in patients with giant cell arteritis (GCA) receiving tocilizumab in combination with glucocorticoids and in patients with GCA receiving only glucocorticoids.

Methods: Posthoc analysis of the Giant-Cell Arteritis Actemra trial including 250 patients who received tocilizumab every week plus a 26-week prednisone taper (n=100), tocilizumab every-other-week plus a 26-week prednisone taper (n=49) or placebo plus a 26-week (n=50) or 52-week (n=51) prednisone taper in the intention-to-treat population. Responders for this analysis were patients who maintained remission (no GCA signs/symptoms and no erythrocyte sedimentation rate elevation) through week 52. Read More

Ther Adv Musculoskelet Dis 2021 18;13:1759720X211009029. Epub 2021 May 18.

Department of Internal Medicine, Nantes University Hospital, Nantes, France.

Background: Giant cell arteritis (GCA) is the most common systemic vasculitis. Relapses are frequent. The aim of this study was to identify relapse risk factors in patients with GCA with complete large-vessel imaging at diagnosis. Read More

J Int Med Res 2021 May;49(5):3000605211018595

Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.

Diffuse large B-cell lymphoma (DLBCL) commonly presents with systemic manifestations including fever, weight loss, and night sweats. Uncommonly, patients with DLBCL can present with musculoskeletal manifestations mimicking polymyalgia rheumatica (PMR). Herein, the case of a 61-year-old woman who presented with pain in the bilateral shoulders, arms, hands, knees, pelvic girdle, and neck with bouts of fever, is presented. Read More

J Vasc Surg Cases Innov Tech 2021 Jun 23;7(2):332-334. Epub 2021 Mar 23.

Division of Vascular Surgery, Department of Surgery, Windsor Regional Hospital, Windsor, Ontario, Canada.

Giant cell arteritis can rarely present as severe ischemia of the upper limbs. The initial management includes high-dose oral glucocorticoids. However, when patients do not respond to medical therapy, surgical revascularization might be required to reinstitute limb perfusion. Read More

Rheumatology (Oxford) 2021 May 25. Epub 2021 May 25.

Rheumatology Department, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, Lisbon, Portugal.