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    Evaluating the utility of autoantibodies for disease activity and relapse in giant cell arteritis.
    J Biol Regul Homeost Agents 2018 Mar-Apr;32(2):313-319
    Department of Rheumatology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
    In patients with giant cell arteritis (GCA), autoantibodies against cytoskeletal elements, cardiolipin, neutrophil cytoplasmic antigens, ferritin, endothelial and smooth muscle cells have been reported, however no updated reviews are available evaluating their clinical utility. Methodology of detection is important, especially for quantitative assays, e.g. Read More

    Temporal headache and jaw claudication may be the key for the diagnosis of giant cell arteritis.
    Med Oral Patol Oral Cir Bucal 2018 Apr 22. Epub 2018 Apr 22.
    Servicio Regional de Cirugia Oral y Maxilofacial Hospital Universitario del Rio Hortega C/Dulzaina nº 2 47012 Valladolid, Espana, Spain
    Background: Temporal artery biopsy (TAB) is a surgical procedure with a low positive yield. The purpose of this study is to determine which variables are the most important in the giant cell arteritis (GCA) diagnosis. The objective of this evaluation is to improve the percentage of positive temporal artery biopsy and if possible, avoid the biopsy in some cases. Read More

    Tocilizumab for the treatment of giant cell arteritis.
    Expert Rev Clin Immunol 2018 Apr 20. Epub 2018 Apr 20.
    b Rheumatology Unit , Azienda Unità Sanitaria Locale IRCCS di Reggio Emilia, and Università di Modena e Reggio Emilia , Italy.
    Introduction: Giant cell arteritis (GCA) is the most frequent type of vasculitis, occurring in people older than 50 years. So far, treatment has been limited to corticosteroids and methotrexate only. Areas covered: Interleukin-6 (IL-6) plays a role in the pathophysiology of GCA. Read More

    Prognosis and Monitoring of Giant Cell Arteritis and Associated Complications.
    Expert Rev Clin Immunol 2018 Apr 20. Epub 2018 Apr 20.
    b Division of Rheumatology , Mayo Clinic College of Medicine , 200 First St SW, Rochester , MN 55901.
    Introduction: Giant cell arteritis (GCA) is the most common systemic vasculitis in people over the age of 50 years. Prospective imaging studies in GCA highlight the systemic nature of this vasculitis. Areas covered: This review summarizes literature using PubMed on complications of GCA and its treatment. Read More

    Transient monocular blindness: Vascular causes and differential diagnoses.
    J Fr Ophtalmol 2018 Apr 16. Epub 2018 Apr 16.
    Centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Service de neurologie B4, neurologie inflammatoire, neuro-ophtalmologie, bâtiment Pierre-Paul-Riquet, place du Dr-Baylac, TSA 40031, 31059 Toulouse cedex 9, France.
    Transient monocular blindness is an acute episode of ischemic origin in which one eye has profound visual loss, followed by full recovery within one hour. Transient monocular blindness most often occurs in the setting of retinal ischemia secondary to carotid embolism, but other mechanisms have been reported, including thrombosis (most often in the setting of giant cell arteritis), hemodynamic disorders (secondary to severe carotid stenosis), or vasospasm. Transient monocular blindness is considered a transient ischemic attack originating in the carotid arteries, and must be managed the same as transient ischemic attack involving the brain, in order to prevent a subsequent stroke. Read More

    Three days of high-dose glucocorticoid treatment attenuates large-vessel 18F-FDG uptake in large-vessel giant cell arteritis but with a limited impact on diagnostic accuracy.
    Eur J Nucl Med Mol Imaging 2018 Apr 18. Epub 2018 Apr 18.
    Department of Rheumatology, Aarhus University Hospital, Nørrebrogade 44, bygning 3, 8000, Århus C, Denmark.
    Purpose: To evaluate the in-treatment diagnostic accuracy of FDG PET/CT in large-vessel giant cell arteritis (LV-GCA) by serial scans before and after a short course of high-dose glucocorticoid treatment.

    Methods: Twenty-four glucocorticoid-naïve patients with new-onset PET/CT verified LV-GCA (pre-treatment baseline PET) were prospectively included. Excluded were patients with a previous history of GCA or polymyalgia rheumatica, LV-GCA-mimicking conditions and patients on immunosuppressive therapy. Read More

    Comparison of magnetic resonance angiography and F-fluorodeoxyglucose positron emission tomography in large-vessel vasculitis.
    Ann Rheum Dis 2018 Apr 17. Epub 2018 Apr 17.
    Systemic Autoimmunity Branch, National Institutes of Health, NIAMS, Bethesda, Maryland, USA.
    Objectives: To assess agreement between interpretation of magnetic resonance angiography (MRA) and F-fluorodeoxyglucose positron emission tomography (PET) for disease extent and disease activity in large-vessel vasculitis (LVV) and determine associations between imaging and clinical assessments.

    Methods: Patients with giant cell arteritis (GCA), Takayasu's arteritis (TAK) and comparators were recruited into a prospective, observational cohort. Imaging and clinical assessments were performed concurrently, blinded to each other. Read More

    Isolated Arteritis of Both Lower Limbs.
    Prague Med Rep 2018 ;119(1):70-75
    Department of Vascular Surgery, Na Homolce Hospital, Prague, Czech Republic.
    Isolated arteritis of the lower limb vessels is an extremely rare condition. The use of modern vascular imaging techniques substantially facilitates and accelerates the diagnostics. In the isolated lower limb arteritis, it is always necessary to exclude Takayasu's and giant-cell arteritis. Read More

    cavernous sinus infection: a case and systematic literature review.
    Pract Neurol 2018 Apr 12. Epub 2018 Apr 12.
    Department of Neurology, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
    A 63-year-old man presented with a 2-month history of progressive right-sided exophthalmos, painful ophthalmoplegia and fevers. As more features developed, he was diagnosed with giant cell arteritis then Tolosa-Hunt syndrome and transiently responded to corticosteroids. A bland cerebrospinal fluid and highly metabolically active brain (F)-fluoro-D-glucose-positron emission tomography suggested lymphoma. Read More

    What is the Current Evidence for Disease Subsets in Giant Cell Arteritis?
    Arthritis Rheumatol 2018 Apr 12. Epub 2018 Apr 12.
    Vasculitis Expertise Center Groningen, University Medical Center Groningen, Groningen, The Netherlands.
    Giant cell arteritis (GCA) is an autoimmune vasculitis affecting large and medium-sized arteries. Ample evidence indicates that GCA is a heterogeneous disease in terms of symptoms, immune pathology and response to treatment. In the current review, we discuss the evidence for disease subsets in GCA. Read More

    FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC.
    Eur J Nucl Med Mol Imaging 2018 Apr 11. Epub 2018 Apr 11.
    University of Groningen, Medical Imaging Center, Department of Nuclear Medicine & Molecular Imaging, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30001, 9700 RB, Groningen, The Netherlands.
    Large vessel vasculitis (LVV) is defined as a disease mainly affecting the large arteries, with two major variants, Takayasu arteritis (TA) and giant cell arteritis (GCA). GCA often coexists with polymyalgia rheumatica (PMR) in the same patient, since both belong to the same disease spectrum. FDG-PET/CT is a functional imaging technique which is an established tool in oncology, and has also demonstrated a role in the field of inflammatory diseases. Read More

    [Current trends in diagnosis and treatment of giant cell arteritis].
    Dtsch Med Wochenschr 2018 Apr 3;143(7):446-450. Epub 2018 Apr 3.
    Med. Klinik und Poliklinik IV, Sektion Angiologie-Gefäßzentrum, Klinikum der Ludwig-Maximilians-Universität, München.
    Giant cell arteritis (GCA) is the most common form of the primary large vessel vasculitides and typically occurs in individuals aged ≥ 50 years. This concise review article discusses current trends in the management of GCA, including important developments in sonographic assessment (B-mode sonography, contrast enhanced ultrasound) and medical treatment (biological treatment with the interleukin-6 receptor alpha inhibitor tocilizumab). Read More

    Recent Advances in Giant Cell Arteritis.
    Curr Rheumatol Rep 2018 Apr 2;20(5):25. Epub 2018 Apr 2.
    Division of Rheumatology Louisiana State University, 1542 Tulane Ave., Box T4M-2, New Orleans, LA, 70112, USA.
    Purpose Of Review: Giant cell arteritis (GCA) is the most common systemic vasculitis. GCA is categorized as a granulomatous vasculitis of large and medium size vessels. Majority of the symptoms and signs of GCA result from involvement of the aorta and its branches intra- and extracranial. Read More

    CT analysis of the aorta in giant-cell arteritis: a case-control study.
    Eur Radiol 2018 Mar 29. Epub 2018 Mar 29.
    Department of Internal Medicine and Clinical Immunology, François-Mitterrand Teaching Hospital, University of Bourgogne-Franche-Comté, Dijon, France.
    Objectives: Giant cell arteritis (GCA) is a large-vessel vasculitis whose diagnosis is confirmed by temporal artery biopsy. However, involvement of large vessels, especially the aorta, can be shown by imaging, which plays an increasing role in GCA diagnosis. The threshold above which aortic wall thickening, as measured by computed tomography (CT), is considered pathological is controversial, with values ranging from 2 to 3 mm. Read More

    Pathogenesis of polymyalgia rheumatica.
    Reumatismo 2018 Mar 27;70(1):10-17. Epub 2018 Mar 27.
    Biomedical Department of Internal Medicine, Division of Rheumatology, University of Palermo.
    Polymyalgia rheumatica (PMR) is a chronic, inflammatory disorder of unknown cause, almost exclusively occurring in people aged over 50 and often associated with giant cell arteritis. The evidence that PMR occurs almost exclusively in individuals aged over 50 may indicate that age-related immune alterations in genetically predisposed subjects contribute to development of the disease. Several infectious agents have been investigated as possible triggers of PMR even though the results are inconclusive. Read More

    Tocilizumab in Giant Cell Arteritis.
    Cardiol Rev 2018 Mar 22. Epub 2018 Mar 22.
    Departments of Medicine, Brown University/Rhode Island Hospital, Providence, RI and New York Medical College/Westchester Medical Center, Valhalla, NY.
    Giant cell arteritis is a granulomatous immune-mediated vasculitis of medium and large vessels. It most commonly affects Caucasian females over the age of 50 and is the most common primary vasculitis in the United States. Treatment of this disease has classically been with high-dose corticosteroids, but this therapy has been associated with severe morbidity and mortality. Read More

    Overall and cause-specific mortality in giant cell arteritis : A meta-analysis.
    Z Rheumatol 2018 Mar 20. Epub 2018 Mar 20.
    Department of Rheumatology, Korea University Anam Hospital, Korea University College of Medicine, 73, Inchon-ro, 02841, Seoul, Seongbuk-gu, Korea (Republic of).
    Objective: This study aimed to assess the all-cause and cause-specific standardized mortality ratios (SMRs) in patients with giant cell arteritis (GCA).

    Methods: We surveyed studies examining all-cause and/or cause-specific SMRs in patients with GCA compared to the general population, using MEDLINE, EMBASE, Cochrane databases, and manual searches. We then performed a meta-analysis of all-cause, sex-specific, region-specific, and cause-specific SMRs in patients with GCA. Read More

    Mortality causes and trends associated with giant cell arteritis: analysis of the French national death certificate database (1980-2011).
    Rheumatology (Oxford) 2018 Mar 14. Epub 2018 Mar 14.
    Department of Internal Medicine, Hospital Saint-Louis, University Paris Diderot, Paris.
    Objectives: Comprehensive analyses of cause-specific death patterns in GCA are sparse. We studied the patterns and time trends in GCA-related mortality using a large death certificate database. Methods; We obtained multiple-cause-of-death data from the French national death certificate database for 1980-2011. Read More

    Negative temporal artery biopsy: predictive factors for giant cell arteritis diagnosis and alternate diagnoses of patients without arteritis.
    Clin Rheumatol 2018 Mar 17. Epub 2018 Mar 17.
    Department of Internal Medicine F And the Rheumatology Unit, The Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel.
    To investigate whether among patients with a negative temporal artery biopsy (TAB) there are clinical features that may differentiate between patients with an eventual diagnosis of giant cell arteritis (GCA) and those without arteritis, and to assess the eventual diagnoses of patients without arteritis. Retrospective analysis of patients with a negative TAB performed between 1/1/2000 and 31/12/2015. Information collected included baseline clinical and laboratory data. Read More

    Development of Giant Cell Arteritis after Treating Polymyalgia or Peripheral Arthritis: A Retrospective Case-control Study.
    J Rheumatol 2018 Mar 15. Epub 2018 Mar 15.
    From the Department of Internal Medicine, University Hospital of Limoges; Functional Unit of Clinical Research and Biostatistics, Limoges School of Medicine, Limoges Cedex; Department of Internal Medicine, Caen University Hospital, Caen, France. E. Liozon, MD, Department of Internal Medicine, University Hospital of Limoges; H. de Boysson, MD, Department of Internal Medicine, Caen University Hospital; F. Dalmay, PhD, Functional Unit of Clinical Research and Biostatistics, Limoges School of Medicine; G. Gondran, MD, Department of Internal Medicine, University Hospital of Limoges; H. Bezanahary, MD, Department of Internal Medicine, University Hospital of Limoges; A.L. Fauchais, MD, PhD, Department of Internal Medicine, University Hospital of Limoges; K.H. Ly, MD, PhD, Department of Internal Medicine, University Hospital of Limoges. Address correspondence to Dr. E. Liozon, Service de Médecine Interne A, CHRU Dupuytren, 2, Avenue Martin Luther-King, 87042 Limoges, France. E-mail: Accepted for publication December 7, 2017.
    Objective: We investigated the development of giant cell arteritis (GCA) in patients with prior diagnoses of isolated polymyalgia rheumatica and/or peripheral arthritis (PMR/PA), and the potentially relevant characteristics of both illnesses in such patients.

    Methods: We retrospectively compared the features of 67 patients at the onset of PMR/PA, and their outcomes, to those of a random group of 65 patients with PMR/PA who did not develop late GCA. We also compared the features and outcomes of patients with late GCA to those of a random sample of patients with more usual GCA (65 with concurrent PMR/PA and 65 without). Read More

    Imaging in diagnosis, outcome prediction and monitoring of large vessel vasculitis: a systematic literature review and meta-analysis informing the EULAR recommendations.
    RMD Open 2018 2;4(1):e000612. Epub 2018 Feb 2.
    Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
    Objectives: To perform a systematic literature review on imaging techniques for diagnosis, outcome prediction and disease monitoring in large vessel vasculitis (LVV) informing the European League Against Rheumatism recommendations for imaging in LVV.

    Methods: Systematic literature review (until 10 March 2017) of diagnostic and prognostic studies enrolling >20 patients and investigating ultrasound, MRI, CT or positron emission tomography (PET) in patients with suspected and/or established primary LVV. Meta-analyses were conducted, whenever possible, obtaining pooled estimates for sensitivity and specificity by fitting random effects models. Read More

    Association between glucocorticoid therapy and incidence of diabetes mellitus in polymyalgia rheumatica and giant cell arteritis: a systematic review and meta-analysis.
    RMD Open 2018 28;4(1):e000521. Epub 2018 Feb 28.
    Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.
    Background: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are almost always treated with glucocorticoids (GCs), but long-term GC use is associated with diabetes mellitus (DM). The absolute incidence of this complication in this patient group remains unclear.

    Objective: To quantify the absolute risk of GC-induced DM in PMR and GCA from published literature. Read More

    Magnetic resonance angiography in giant cell arteritis: results of a randomized controlled trial of tocilizumab in giant cell arteritis.
    Rheumatology (Oxford) 2018 Feb 23. Epub 2018 Feb 23.
    Department of Rheumatology, Immunology and Allergology, University Hospital, University of Bern, Bern, Switzerland.
    Objective: To analyse magnetic resonance angiographic (MRA) vessel wall signals from a randomized controlled trial of tocilizumab (TCZ) to treat GCA.

    Methods: Participants were assigned in a 2:1 ratio to receive either TCZ + glucocorticoids (GCs) or placebo + GC infusions at 4-week intervals for 52 weeks. GCs were started at 1 mg/kg/day, then tapered to 0. Read More

    Checks and Balances in Autoimmune Vasculitis.
    Front Immunol 2018 22;9:315. Epub 2018 Feb 22.
    Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
    Age-associated changes in the immune system including alterations in surface protein expression are thought to contribute to an increased susceptibility for autoimmune diseases. The balance between the expression of coinhibitory and costimulatory surface protein molecules, also known as immune checkpoint molecules, is crucial in fine-tuning the immune response and preventing autoimmunity. The activation of specific inhibitory signaling pathways allows cancer cells to evade recognition and destruction by the host immune system. Read More

    Tocilizumab in the treatment of giant cell arteritis.
    Immunotherapy 2018 Mar 5;10(6):465-472. Epub 2018 Mar 5.
    Division of Rheumatology, Department of Medicine III, University Medical Center & Faculty of Medicine Carl Gustav Carus at the TU Dresden, Dresden, Germany.
    Giant cell arteritis is a systemic vasculitis of large vessels, manifesting mainly as temporal arteritis or large vessel vasculitis of the aorta and its branches. Glucocorticoid therapy is essential and so far had to be continued over a period of 1.5-2 years, resulting in relevant morbidity through adverse effects. Read More

    A Review of Recent Advances Using Tocilizumab in the Treatment of Rheumatic Diseases.
    Rheumatol Ther 2018 Mar 3. Epub 2018 Mar 3.
    Genentech, South San Francisco, CA, USA.
    Tocilizumab (TCZ) is the first humanized anti-interleukin-6 (IL-6) receptor monoclonal antibody approved for the treatment of patients with rheumatoid arthritis (RA), Castleman's disease, polyarticular and systemic juvenile idiopathic arthritis, and, most recently, giant cell arteritis as well as for the treatment of chimeric antigen receptor T cell therapy-induced cytokine release syndrome. The global clinical development program for TCZ provides a wealth of clinical data on intravenous TCZ, and more recent studies in patients with RA have provided evidence characterizing the role of intravenous TCZ as monotherapy in early disease and led to the introduction of a subcutaneous formulation of TCZ. In addition, recently published open-label extension and observational studies continue to support the long-term efficacy and safety of TCZ in both clinical trial and real-world settings. Read More

    Treatments for giant cell arteritis: Meta-analysis and assessment of estimates reliability using the fragility index.
    Semin Arthritis Rheum 2018 Jan 6. Epub 2018 Jan 6.
    Evidence-based Practice Center, Mayo Clinic College of Medicine and Science, Rochester, MN.
    Background: To better communicate the results of randomized controlled trials (RCTs) of giant cell arteritis (GCA), we propose the use of the fragility index (FI), which is an intuitive measure defined as the minimum number of subjects whose status would have to change (e.g., from having the outcome to not) to render a statistically significant result nonsignificant, or vice-versa. Read More

    Isolated large vessel pulmonary vasculitis leading to pulmonary artery aneurysm formation: a case report and literature review.
    Pulm Circ 2018 Apr-Jun;8(2):2045894018765346. Epub 2018 Feb 28.
    1 Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
    Pulmonary artery (PA) vasculitis occurs in association with primary vasculitides-in particular, giant cell arteritis, Takayasu's arteritis, or Behçet's disease-or secondary vasculitis as a result of infections or malignancy. However, PA vasculitis in isolation and with concomitant aneurysmal dilation is an unusual finding. We present a rare case of PA aneurysm secondary to isolated PA vasculitis in an asymptomatic patient with no features of systemic vasculitis. Read More

    Stroke as an atypical initial presentation of giant cell arteritis.
    BMC Geriatr 2018 02 21;18(1):55. Epub 2018 Feb 21.
    University of Ottawa and The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Box 678, Ottawa, Ontario, K1Y 4E9, Canada.
    Background: Giant cell arteritis (GCA) is an immune mediated inflammatory disease of medium and large arteries which afflicts older people. The classical presentation features include: headache, visual disturbances, and jaw claudication. Patients diagnosed with GCA have also been observed to be at higher risk for the subsequent development of strokes. Read More

    Long-term continuation of methotrexate therapy in giant cell arteritis patients in clinical practice.
    Clin Exp Rheumatol 2018 Jan-Feb;36(1):173. Epub 2018 Feb 6.
    Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IDISSC), Hospital Clinico San Carlos, Madrid, Spain.

    Clinical correlation of biopsy results in patients with temporal arteritis.
    Rev Assoc Med Bras (1992) 2017 Nov;63(11):953-956
    Professor of Cardiovascular Surgery, Trakya University, Edirne, Turkey.
    Objective: Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. Read More

    Breast granulomatosis with polyangiitis mimicking breast cancer.
    Pathologica 2017 Dec;109(4):405-407
    Pathology Unit, Azienda USL Valle d'Aosta, Hospital "Parini", Aosta, Italy.
    Inflammatory lesions of the breast encompass primary reactive processes and local manifestation of systemic diseases. They are very rare and they are generally treated without resort to biopsy. Nevertheless they could be clinically challenge mimicking malignant process and needing surgery to reach a correct diagnosis. Read More

    Challenges of diagnosis and management of giant cell arteritis in general practice: a multimethods study.
    BMJ Open 2018 02 3;8(2):e019320. Epub 2018 Feb 3.
    Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, UK.
    Background: In the UK, general practitioners (GPs) are usually the first medical contact for patients with suspected giant cell arteritis (GCA). While rare, it is critical not to miss, as delayed treatment can lead to significant complications including permanent visual loss. To date, little is known about the approach and challenges to diagnosis and management of GCA by GPs. Read More

    Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients.
    Autoimmun Rev 2018 Apr 7;17(4):391-398. Epub 2018 Feb 7.
    Department of Internal Medicine, Caen University Hospital, Caen, France; University of Normandy, Caen, France.
    Objectives: Large-vessel involvement (LVI) can occur in giant-cell arteritis (GCA) and may represent a distinct disease subgroup with a higher risk for aortic dilation. This study aimed to better characterize the presentation and evolution of LVI in patients with GCA.

    Patients And Methods: A retrospective multicenter study enrolled 248 GCA patients with LVI and 301 GCA patients without LVI on imaging. Read More

    Approach to a Patient with Diplopia in the Emergency Department.
    J Emerg Med 2018 Feb 6. Epub 2018 Feb 6.
    Department of Ophthalmology & Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
    Background: Diplopia can be the result of benign or life-threatening etiologies. It is imperative for the emergency physician to be proficient at assessing diplopia and recognize when urgent referral or neuroimaging is required.

    Objective: The first part of this review highlights a simple framework to arrive at the appropriate disposition of diplopic patients presenting to the emergency department (ED). Read More

    Characterization of serological markers of healed/healing arteritis and giant cell arteritis.
    Can J Ophthalmol 2018 Feb 9;53(1):39-44. Epub 2017 Oct 9.
    University of Ottawa Eye Institute, Ottawa, Ont; Ottawa Hospital Research Institute, Ottawa, Ont.. Electronic address:
    Objective: Temporal artery biopsy (TAB) is the gold standard for confirming the diagnosis of giant cell arteritis (GCA) when positive. However, the clinical significance of healed/healing (HH) arterial injury on TAB is not well understood. The purpose of this study was to evaluate the clinical significance of this finding on TAB by determining its association with seromarkers typically predictive of GCA. Read More

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