Search Our Scientific Publications & Authors

Intern Med 2019 Apr 17. Epub 2019 Apr 17.

Department of Clinical Research, National Hospital Organization Osaka Minami Medical Center, Japan.

A 66-year-old woman with symptoms of fatigue and headache was diagnosed with giant cell arteritis (GCA). Fluorodeoxyglucose (FDG)-PET/computed tomography (CT) revealed the strong accumulation of FDG in the descending aorta, abdominal aorta, bilateral subclavian artery, and total iliac artery. Diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) showed signal enhancement at the descending aorta and abdominal aorta. Read More

Rheumatol Int 2019 Apr 16. Epub 2019 Apr 16.

Clínica de Diagnóstico Por Imagem (CDPI), Avenida das Américas, 4666, 302A, 303, 307, 325, 326, Barra da Tijuca, Rio de Janeiro, RJ, 2640-102, Brazil.

Pathog Immun 2019 15;4(1):105-123. Epub 2019 Mar 15.

Genomic Medicine Institute; Lerner Research Institute; Cleveland Clinic; Cleveland, Ohio.

Objective: We sought to characterize microbiomes of thoracic aortas from patients with non-infectious aortitis due to giant cell arteritis (GCA) and clinically isolated aortitis (CIA) and to compare them to non-inflammatory aorta aneurysm controls. We also compared microbiomes from concurrently processed and separately reported temporal arteries (TA) and aortas.

Methods: From 220 prospectively enrolled patients undergoing surgery for thoracic aorta aneurysm, 49 were selected. Read More

Pathog Immun 2019 12;4(1):21-38. Epub 2019 Feb 12.

Genomic Medicine Institute; Lerner Research Institute; Cleveland Clinic; Cleveland, Ohio.

Objective: A role for microorganisms in giant cell arteritis (GCA) has long been suspected. We describe the microbiomes of temporal arteries from patients with GCA and controls.

Methods: Temporal artery biopsies from patients suspected to have GCA were collected under aseptic conditions and snap-frozen. Read More

Postgrad Med J 2019 Apr 16. Epub 2019 Apr 16.

Neuro-ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Ann Nucl Med 2019 Apr 11. Epub 2019 Apr 11.

Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France.

Objective: The purpose of our study was to assess the diagnostic performance of F-FDG PET-CT for large vessel involvement in patients with suspected giant cells arteritis (GCA) and a negative temporal artery biopsy (TAB).

Methods: We conducted a retrospective study in a cohort of patients with suspected GCA and negative TAB who underwent an F-FDG PET-CT. Ten vascular segments were studied using a visual score and a semi-quantitative method based on SUVmax ratio with respect to liver uptake. Read More

J Am Coll Cardiol 2019 Apr;73(14):1824-1826

Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Vascular Research Division, Department of Pathology and the Center of Excellence in Vascular Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

J Am Coll Cardiol 2019 Apr;73(14):1811-1823

Department of Medicine, Division of Immunology and Rheumatology, Stanford University School of Medicine, Stanford, California. Electronic address:

Background: In giant cell arteritis, vessel-wall infiltrating CD4 T cells and macrophages form tissue-destructive granulomatous infiltrates, and the artery responds with a maladaptive response to injury, leading to intramural neoangiogenesis, intimal hyperplasia, and luminal occlusion. Lesion-residing T cells receive local signals, which represent potential therapeutic targets.

Objectives: The authors examined how CD28 signaling affects vasculitis induction and maintenance, and which pathogenic processes rely on CD28-mediated T-cell activation. Read More

J Surg Case Rep 2019 Apr 3;2019(4):rjz099. Epub 2019 Apr 3.

Department of ENT, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.

Potts puffy tumour (PPT) is a subperiosteal abscess arising from frontal bone osteomyelitis. We present a case of a 75-year-old lady with headache and a forehead swelling who was initially treated for sinusitis and giant cell arteritis in a primary care setting, but failed to improve. Following clinical deterioration and further investigation, CT appearances were consistent with a diagnosis of PPT and an extra-axial collection. Read More

Nagoya J Med Sci 2019 Feb;81(1):151-158

Department of Nephrology, Toyohashi Municipal Hospital, Toyohashi, Japan.

Recent epidemiological or immunopathological studies demonstrate the possible association between giant cell arteritis and infectious agents including . A 62-year-old Japanese man with type 1 diabetes mellitus developed biopsy-proven giant cell arteritis after acute upper respiratory infection. Serological examination indicated concurrent re-infection with . Read More

Am J Ophthalmol 2019 Apr 4. Epub 2019 Apr 4.

Ophthalmology Unit, S.Orsola-Malpighi University Hospital, University of Bologna, Bologna, Italy.

Purpose: To compare choroidal vascularity index (CVI) in patients with arteritic anterior ischemic optic neuropathy (A-AION), non-arteritic anterior ischemic optic neuropathy (NA-AION) and control subjects.

Design: Retrospective cross-sectional study.

Methods: This study was conducted at the Ophthalmology Unit of the S. Read More

Neurol Clin 2019 May 16;37(2):335-344. Epub 2019 Mar 16.

Department of Neurology, Division of Neuro-Epidemiology, New York University School of Medicine, New York, NY 10016, USA; School of Public Health, City University of New York, New York, NY, USA. Electronic address:

"Giant cell arteritis (GCA) is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries comprising overlapping phenotypes of cranial arteritis and extracranial GCA. Vascular complications are generally due to delay in diagnosis and initiation of effective treatment. Advancements in MRI and MR angiography, computed tomography angiography, 18fluoro-deoxyglucose/PET, and color duplex ultrasonography have led to improved diagnosis. Read More

Arthritis Care Res (Hoboken) 2019 Apr 5. Epub 2019 Apr 5.

Univ Lyon, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, CNRS, Claude Bernard University Lyon, F-69003, France.

Objective: The relapse rate of patients with giant cell arteritis (GCA) treated with glucocorticoids (GC) alone varied widely in observational series and randomized controlled trials (RCT). The purpose of this systematic review was to evaluate the prevalence of relapse and predisposing factors in patients receiving GC alone.

Methods: We searched MedLine up to December 2017. Read More

Clin Exp Rheumatol 2019 Mar 19. Epub 2019 Mar 19.

Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

Objectives: To evaluate the association between disease activity and serum levels of pentraxin-3 (PTX-3) and lysosomal-associated membrane protein-2 (LAMP-2) as well as the acute reactants in Chinese Takayasu's arteritis (TAK) patients.

Methods: The serum PTX-3 and LAMP-2 levels were tested in 98 TAK patients and 40 age- and gender-matched healthy controls. The disease activity of these TAK patients was assessed according to the National Institute of Health (NIH) and Abatacept in giant cell arteritis and Takayasu's arteritis (AGATA) criteria, respectively. Read More

J Rheumatol 2019 Apr;46(4):439

Department of Internal Medicine, Service de Médecine Interne, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Hôpital Bretonneau, Tours, France.

Rheumatology (Oxford) 2019 Mar 29. Epub 2019 Mar 29.

University Claude Bernard Lyon 1.

PLoS One 2019 29;14(3):e0210845. Epub 2019 Mar 29.

Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.

Background: Temporal artery biopsy (TAB) is useful in assisting with giant cell arteritis (GCA) diagnosis but lacks sensitivity. The aim of our study was to assess the diagnostic impact of TAB histology in patients with suspected GCA on hospital admission.

Methods: A prospectively maintained database was queried for all TABs performed between 1-1-2000 until 31-12-2017 at the University Hospital of Ioannina. Read More

Rheumatology (Oxford) 2019 Mar 26. Epub 2019 Mar 26.

Department of Rheumatology, Immunology and Allergology, University Hospital (Inselspital)University of Bern.

Objective: It is currently unknown how long GCA should be treated with tocilizumab. In the first randomized controlled trial, the biologic agent was stopped after 52 weeks. We therefore studied what proportion of patients relapsed, when relapses occurred and whether factors might predict relapse after tocilizumab treatment discontinuation. Read More

Semin Arthritis Rheum 2019 Mar 2. Epub 2019 Mar 2.

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

Background: We examined the initial features, course, and prognosis of giant cell arteritis (GCA) in patients ≥ 85years of age (≥85 year) and compared them to those of younger patients.

Methods: The present retrospective study included all patients who were newly diagnosed with GCA in the Internal Departments of two French University Hospitals from 1976 or 1998 to 2017 and who were followed up for at least 6 months. Logistic regression analyses were conducted to identify baseline and prognostic characteristics associated with being ≥85 year. Read More

Isr Med Assoc J 2019 Mar;21(3):158-162

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: The hygiene theory represents one of the environmental facets that modulate the risk for developing autoimmune diseases. There is a reverse correlation between the presence of helminthes and flares of autoimmune diseases, which explains the rise in incidence of certain autoimmune diseases in developed countries. The protective properties of certain helminthes are attributed to their secretory compounds which immunomodulate the host immune network in order to survive. Read More

Clin Sci (Lond) 2019 Apr 4;133(7):839-851. Epub 2019 Apr 4.

Department of Biochemical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, U.K.

We have reported the existence of a distinct neutrophil phenotype in giant cell arteritis (GCA) patients arising at week 24 of steroid treatment. In the present study, we investigated whether longitudinal analysis of neutrophil phenotype in patients with polymyalgia rheumatica (PMR) could reveal a novel association with disease status and immune cell cross-talk. Thus, we monitored PMR patient neutrophil phenotype and plasma microvesicle (MV) profiles in blood aliquots collected pre-steroid, and then at weeks 1, 4, 12 and 24 post-steroid treatment. Read More

Ann Rheum Dis 2019 Mar 21. Epub 2019 Mar 21.

Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany.

Giant cell arteritis (GCA) represents the most common form of primary systemic vasculitis and is frequently associated with comorbidities related to the disease itself or induced by the treatment. Systematically collected data on disease course, treatment and outcomes of GCA remain scarce. The aim of this EULAR Task Force was to identify a core set of items which can easily be collected by experienced clinicians, in order to facilitate collaborative research into the course and outcomes of GCA. Read More

Curr Cardiol Rep 2019 Mar 18;21(5):34. Epub 2019 Mar 18.

Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.

Purpose Of Review: This review aims to discuss the use of fluorodeoxyglucose (FDG) positron emission tomography (PET/CT) for diagnosis and management of patients with large-vessel vasculitis (LVV).

Recent Findings: Incidence of LVV is likely underestimated, in part due to its non-specific symptoms. Nevertheless, early diagnosis of LVV is essential to initiate timely therapy in order to prevent vascular complications, such as stenoses and aneurysms. Read More

J Rheumatol 2019 Mar 15. Epub 2019 Mar 15.

From the Department of Internal Medicine, Department of Biostatistics and Department of Pathology, Caen University Hospital, Caen, France. Address correspondence to Hubert de Boysson, MD, MSc, Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000 Caen, France. E-mail:

Objective: To identify characteristics and factors associated with relapse and glucocorticoid (GC) dependence in patients with giant-cell arteritis (GCA).

Methods: We retrospectively analyzed 326 consecutive patients with GCA followed for at least 12 months. Factors associated with relapse and GC dependence were identified in multivariable analyses. Read More

J Rheumatol 2019 Mar 15. Epub 2019 Mar 15.

Systemic Autoimmunity Branch, National Institutes of Health, NIAMS, Bethesda, MD, USA; Division of Rheumatology, Georgetown University, Washington DC, USA; National Institutes of Health, Clinical Center, Radiology and Imaging Sciences, Bethesda, MD, USA; Division of Rheumatology and Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA. Address correspondence to Peter C. Grayson, MD, MSc, National Institutes of Health / NIAMS, 10 Center Drive, Building 10, 10N Rm 311D, Bethesda, MD 20892 Email:

Objective: Disease activity in large-vessel vasculitis (LVV) is traditionally assessed by clinical and serological parameters rather than vascular imaging. This study determined the effect of treatment on 18F-fluorodeoxyglose positron emission tomography (FDG-PET) vascular activity in relationship to clinical and serologic-based assessments.

Methods: Patients with giant cell arteritis (GCA) or Takayasu's arteritis (TAK) were prospectively evaluated at 6-month intervals in an observational cohort. Read More

Rheumatol Int 2019 Mar 14. Epub 2019 Mar 14.

Department of Rheumatology and Immunology, Peking University Third Hospital, No. 49, North Garden Road, Beijing, 100191, China.

Systemic vasculitis involving the breast is a rare clinical condition and may mimic breast cancer or mastitis clinically or radiographically. Here, we report a case of polyarteritis nodosa (PAN) with breast involvement and perform a literature review of published cases of systemic vasculitis affecting the breast to better understand this disorder. We report a case of PAN affecting the right breast in a young woman. Read More

Rheumatol Int 2019 Apr 14;39(4):743-750. Epub 2019 Mar 14.

Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskisehir, Turkey.

Tocilizumab (TCZ) may rarely cause hematological side effects including neutropenia and thrombocytopenia. TCZ is essentially expected to lower the fibrinogen levels to stay within the normal range, but TCZ-induced hypofibrinogenemia has been rarely reported in literature. Although it may remain asymptomatic, hypofibrinogenemia has clinical significance owing to the tendency of the condition to result in bleeding. Read More

IEEE Trans Ultrason Ferroelectr Freq Control 2019 Mar;66(3):472-480

The objective was to provide a clinical setup for photoacoustic imaging (PAI) of the temporal artery in humans and to describe the challenges encountered and methods of overcoming them. The temporal artery was examined in seven patients with suspect giant-cell arteritis (GCA), both in vivo and ex vivo, and the results were compared to that of histology. To adapt PAI to the human studies, the transducer was fixed to an adjustable arm to reduce motion artifacts, and a stepping motor was developed to enable 3-D scanning. Read More

J Clin Med 2019 Mar 12;8(3). Epub 2019 Mar 12.

Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, Korea.

The 1858T allele in the protein tyrosine phosphatase non-receptor type 22 (PTPN22) locus shows one of the strongest and most consistent genetic associations with autoimmune diseases. We synthesized all meta-analyses reporting a genetic association of the PTPN22 1858T C/T polymorphism with autoimmune diseases. This work examined their validity to discover false positive results under Bayesian methods. Read More

Clin Ophthalmol 2019 21;13:421-430. Epub 2019 Feb 21.

Ophthalmology, Harvard University, Boston, MA, USA.

Purpose: To develop and validate neural network (NN) vs logistic regression (LR) diagnostic prediction models in patients with suspected giant cell arteritis (GCA). Design: Multicenter retrospective chart review.

Methods: An audit of consecutive patients undergoing temporal artery biopsy (TABx) for suspected GCA was conducted at 14 international medical centers. Read More

Postepy Dermatol Alergol 2019 Feb 22;36(1):25-28. Epub 2019 Feb 22.

Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdansk, Gdansk, Poland.

Giant cell arteritis is the most common systemic vasculitis. It selectively affects large- and medium-sized arteries. Arterial wall inflammation leads to luminal occlusion and tissue ischemia, which cause the clinical manifestations of this vasculitis. Read More

Can J Ophthalmol 2019 Feb 11;54(1):e1-e3. Epub 2018 Jun 11.

Baylor College of Medicine, Houston, Texas; Department of Ophthalmology and the Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, N.Y; Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center, Houston, Texas; Texas A & M College of Medicine, Bryan, Texas; Weill Cornell Medicine; Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

Can J Ophthalmol 2019 Feb 12;54(1):119-124. Epub 2018 Nov 12.

Department of Ophthalmology, Queens University, Kingston, Ont.

Objective: The incidence of giant cell arteritis (GCA) is insufficiently documented for Canada, but important to ascertain for public health planning. We estimate the incidence of biopsy-proven GCA (BPGCA) in Kingston, Ontario, and for the province of Ontario.

Method: The number of cases of BPGCA was tabulated from retrospective chart review of all temporal artery biopsies (TABx) in Kingston, Ontario from 2011-15. Read More

Can J Ophthalmol 2019 Feb 31;54(1):116-118. Epub 2018 Aug 31.

Department of Ophthalmology, Harvard Medical School, Boston, MA, United States.; Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, Ont.

Objective: Support vector machines (SVM) is a newer statistical method that has been reported to be advantageous to traditional logistic regression for clinical classification. We determine if SVM can better predict the results of temporal artery biopsy (TABx) for giant cell arteritis compared to logistic regression.

Method: A database of 530 TABx patients with 10 covariates was used and randomly split into training and test sets. Read More

Arthritis Rheumatol 2019 Mar 8. Epub 2019 Mar 8.

Departments of Rheumatology, Nuclear Medicine and Anatomical Pathology, Royal North Shore Hospital, St Leonards, Sydney, NSW, 2065, Australia.

Objectives: PET/CT has not been well studied as a first-line test for giant cell arteritis (GCA). In part this is due to historical limitations in visualizing the cranial arteries. The Giant Cell Arteritis and PET Scan (GAPS) study assessed the accuracy of a newer generation PET/CT of the head, neck and chest for GCA. Read More

BMJ Case Rep 2019 Mar 6;12(3). Epub 2019 Mar 6.

Vasculitis, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Giant cell arteritis (GCA) is the most common vasculitis in adults and blindness is a common complication if left untreated. Oral glucocorticoids are the mainstay of treatment and if started promptly, loss of vision can usually be prevented. We present the case of a 77-year-old man who developed irreversible bilateral blindness after a confirmed diagnosis of GCA and oral steroid treatment. Read More

Autoimmun Rev 2019 May 4;18(5):476-483. Epub 2019 Mar 4.

Department of internal medicine, Hôtel-Dieu, CHU Nantes, Nantes, France. Electronic address:

Introduction: Juvenile temporal arteritis (JTA) is a recently-described and little-known inflammatory disease and its etiology is undetermined. Less than forty cases have been published. This paper is aimed at reporting the largest JTA series and to compare it to literature data to better evaluate its characteristics at diagnosis, its evolution and treatment options. Read More

Scand J Rheumatol 2019 Mar 6:1-7. Epub 2019 Mar 6.

g Rheumatology, Department of Medical Sciences , Uppsala University , Uppsala , Sweden.

Objective: To develop evidence-based guidelines for the management of giant cell arteritis (GCA) as a complement to guidelines in other areas of rheumatology, issued by the Swedish Society of Rheumatology.

Methods: A working group selected key areas for recommendations, reviewed the available evidence, and wrote draft guidelines. These were discussed and revised according to standard procedures within the Swedish Society of Rheumatology, including a one-day meeting open to all members. Read More

Scand J Rheumatol 2019 Mar 5:1-3. Epub 2019 Mar 5.

a Department of Rheumatology , Hospital of Southern Norway , Kristiansand , Norway.

Arthritis Rheumatol 2019 Mar 5. Epub 2019 Mar 5.

Roche Products Ltd., Welwyn Garden City, United Kingdom.

Objective: To evaluate glucocorticoid doses and serological findings in patients with giant cell arteritis (GCA) flares.

Methods: Patients with GCA were randomly assigned to receive double-blind dosing with subcutaneous tocilizumab (TCZ) 162 mg weekly plus 26-week prednisone (TCZ-QW+Pred-26), every-other-week TCZ plus 26-week prednisone (TCZ-Q2W+Pred-26), placebo plus 26-week prednisone (PBO+Pred-26), or placebo plus 52-week prednisone (PBO+Pred-52). Outcomes were prednisone dose, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) at the time of flare and remission during 52 weeks. Read More

J Infect Dis 2019 Mar 5. Epub 2019 Mar 5.

Department of Neurology, University of Colorado School of Medicine, Aurora.

Background: In temporal arteries (TAs) from giant cell arteritis patients, varicella zoster virus (VZV) is seen in perineurial cells that surround adventitial nerve bundles and form the peripheral nerve-extrafascicular tissue barrier (perineurium). We hypothesized that during VZV reactivation from ganglia, virus travels transaxonally and disrupts the perineurium to infect surrounding cells.

Methods: Mock- and VZV-infected primary human perineurial cells (HPNCs) were examined for alterations in claudin-1, E-cadherin and N-cadherin. Read More

Sci Rep 2019 Mar 4;9(1):3376. Epub 2019 Mar 4.

Nuclear Medicine Unit, Oncology and Advanced Technologies Department, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123, Reggio Emilia, Italy.

MiRNAs are single stranded RNAs of 18-22 nucleotides. They are promising diagnostic and prognostic markers for several pathologies including tumors, neurodegenerative, cardiovascular and autoimmune diseases. In the present work the development and characterization of anti-miRNA radiolabeled probes based on peptide nucleic acids (PNAs) for potential non-invasive molecular imaging in vivo of giant cell arteritis are described. Read More

Yakugaku Zasshi 2019 ;139(3):491-495

Department of Hospital Pharmacy, Kansai Medical University.

Nivolumab, an anti-programmed cell death 1 antibody, has been approved for the treatment of unresectable advanced non-small-cell lung cancer (NSCLC). Although immune-related adverse events (irAEs) such as dermatologic, digestive, endocrine, hepatic, and pulmonary toxicities are known to occur upon administration of immune checkpoint inhibitors, case reports of polymyalgia rheumatica (PMR) associated with nivolumab use are rare. We report a case of an NSCLC patient who developed PMR during treatment with nivolumab and received corticosteroids. Read More

Curr Rheumatol Rev 2019 Feb 27. Epub 2019 Feb 27.

Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico,151 - 00161, Rome, . Italy.

Giant Cell Arteritis (GCA), or Horton's Arteritis, is a chronic form of vasculitis of the large and medium vessels, especially involving the extracranial branches of the carotid arteries, in particular, the temporal artery, with the involvement of the axillary, femoral and iliac arteries too. Arterial wall inflammation leads to luminal occlusion and tissue ischemia, which is responsible for the clinical manifestations of the disease. A substantial number of patients affected by GCA present head and neck symptoms, including ocular, neurological and otorhinolaryngological manifestations. Read More

Arthritis Rheumatol 2019 Mar 2. Epub 2019 Mar 2.

Brigham and Women's Hospital, Boston, Massachusetts, United States.

Imaging now plays an important role in the evaluation of giant cell arteritis (GCA). A growing body of literature supports the use of ultrasound, CT, MRI and PET to assist with diagnosis. EULAR recently recommended ultrasound or high-resolution MRI as diagnostic tests for GCA involving the superficial cranial arteries; ultrasound, MRI, CT, and PET are recommended for evaluating large arteries, with the caveat that ultrasound has limited value for detecting aortitis. Read More

J Rheumatol 2019 Mar 1. Epub 2019 Mar 1.

From the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Division of Rheumatology, Immunology, and Allergy, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. Address correspondence to Robert F. Padera, Jr., MD, PhD, Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02115. e-mail:

Objective: A variety of infectious agents, including varicella zoster virus (VZV), have been hypothesized to play a role in the pathogenesis of giant cell arteritis (GCA). The detectability of the virus in patients with GCA has been controversial. To further investigate an association between GCA and VZV infection, ten years of GCA cases were evaluated for VZV by immunohistochemistry (IHC). Read More

Ophthalmol Ther 2019 Mar 1. Epub 2019 Mar 1.

Birmingham Neuro-Ophthalmology, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, B15 2WB, UK.

Improving understanding of the underlying pathophysiology of giant cell arteritis (GCA) is transforming clinical management by identifying novel avenues for targeted therapies. One key area of concern for both clinicians and patients with GCA is glucocorticoid (GC) morbidity. The first randomised controlled trials of targeted treatment to reduce cumulative GC use in GCA have been published, with tocilizumab, an interleukin (IL)-6 receptor inhibitor, now the first ever licensed treatment for GCA. Read More

Ann Lab Med 2019 Jul;39(4):345-357

Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, West Midlands, UK.

The platelet-to-lymphocyte ratio (PLR) has emerged as an informative marker revealing shifts in platelet and lymphocyte counts due to acute inflammatory and prothrombotic states. PLR has been extensively examined in neoplastic diseases accompanied by immune suppression and thrombosis, which can be predicted by combined blood cell counts and their ratios. Several large observational studies have demonstrated the value of shifts in PLR in evaluating the severity of systemic inflammation and predicting infections and other comorbidities, in inflammatory rheumatic diseases. Read More

Rheumatology (Oxford) 2019 Feb 25. Epub 2019 Feb 25.

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

Objective: GCA, a systemic vasculitis, is characterized by an IL-6-dependent acute-phase response. This response is typically suppressed by treatment rendering CRP/ESR unreliable for monitoring vascular inflammation. Also, there are no accurate biomarkers predicting a non-favourable disease course. Read More

J Clin Rheumatol 2019 Feb 19. Epub 2019 Feb 19.

Department of General Internal Medicine University Hospitals Leuven Herestraat 49, 3000 Leuven, Belgium