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    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.

    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 Feb 7. 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

    Profile of tocilizumab and its potential in the treatment of giant cell arteritis.
    Eye Brain 2018 23;10:1-11. Epub 2018 Jan 23.
    Department of Rheumatology, Southend University Hospital, Southend-on-Sea, UK.
    Giant cell arteritis (GCA) remains a medical emergency due to the threat of permanent sight loss. High-dose glucocorticoids (GCs) are effective in inducing remission in the majority of patients, however, relapses are common which lengthen GC therapy. GC toxicity remains a major morbidity in this group of patients, and conventional steroid-sparing therapies have not yet shown enough of a clinical benefit to change the standard of care. Read More

    IL-6 expression is correlated with increased T-cell proliferation and survival in the arterial wall in giant cell arteritis.
    Cardiovasc Pathol 2018 Jan 9;33:55-61. Epub 2018 Jan 9.
    Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, British Columbia, Canada. Electronic address:
    Giant cell arteritis (GCA) is the most common vasculitis in adults affecting large and medium-sized arteries. IL-6 and T cell accumulation within the arterial wall contribute to the pathogenesis of GCA, and blockade of IL-6 activity is efficacious in its treatment. We examined the relationship between levels of IL-6 expression and immunological processes that control the expansion of T cells in GCA-positive temporal artery biopsies. Read More

    Mortality in Patients with Giant Cell Arteritis: A Cohort Study in UK Primary Care.
    Arthritis Care Res (Hoboken) 2018 Feb 6. Epub 2018 Feb 6.
    Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA, USA.
    Objective: To examine whether giant cell arteritis (GCA) is associated with increased all-cause mortality and whether mortality differs according to age, sex, and calendar year of cohort entry.

    Methods: Using the UK-based Clinical Practice Research Datalink we identified 9778 newly diagnosed GCA patients from 1990-2014, and up to 10 non-vasculitis patients randomly matched to each case on age, sex, practice and years of history before cohort entry. We used Cox regression to estimate adjusted hazard ratios (HRs) for mortality of GCA patients in comparison to non-vasculitis patients, then stratified by age, sex, and calendar year of cohort entry. Read More

    A case of giant cell arteritis associated with a culture proven Coxiella burnetii aortitis.
    Int J Infect Dis 2018 Feb 2. Epub 2018 Feb 2.
    Aix Marseille Univ, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.
    We report a case of proven Coxiella burnetii aortitis, possibly associated with a giant cell arteritis (GCA). A seventy-two-year-old man, who is a hunter, presented with weight loss, fevers, jaw claudication and hardened temporal arteries associated with a persistent inflammatory syndrome and an arteritis of the whole aorta including the brachiocephalic arteries on the 18F-FDG PET/CT. A diagnosis of GCA was retained and a treatment with prednisolone was started. Read More

    Diagnosis and Management of Headache in Older Adults.
    Mayo Clin Proc 2018 Feb;93(2):252-262
    Department of Neurology, Mayo Clinic Hospital, Phoenix, AZ. Electronic address:
    Headache is a common, disabling neurologic problem in all age groups, including older adults. In older adults, headache is most likely a primary disorder, such as tension-type headache or migraine; however, there is a higher risk of secondary causes, such as giant cell arteritis or intracranial lesions, than in younger adults. Thus, based on the headache history, clinical examination, and presence of headache red flags, a focused diagnostic evaluation is recommended, ranging from blood tests to neuroimaging, depending on the headache characteristics. Read More

    Noninfectious aortitis: Experience with tocilizumab in a regional hospital.
    Reumatol Clin 2018 Feb 1. Epub 2018 Feb 1.
    Hospital Universitario de Araba, Vitoria-Gasteiz, España.
    Objectives: Describe patients with noninfectious aortitis and their response to treatment in a regional hospital.

    Methods: Review of patients with noninfectious aortitis, diagnostic technique used and immunosuppressive therapy received.

    Results: We report 8 patients (7 women and one man) diagnosed with aortitis by positron emission tomography (PET). Read More

    Cerebrovascular events in Takayasu arteritis: a multicenter case-controlled study.
    J Neurol 2018 Feb 1. Epub 2018 Feb 1.
    Service de Médecine 2, Institut e3m, Centre National de Référence Maladies Systémiques Rares, Lupus systémique et Syndrome des Anticorps Antiphospholipides, Assistance Publique-Hôpitaux de Paris, Hôpital de la Pitié-Salpêtrière, 75013, Paris, France.
    Objectives: Takayasu arteritis (TA) is a giant cell arteritis usually affecting young women and characterized by inflammatory and ischemic signs of large vessel involvement, including extracranial cerebral arteries. The impact of stroke on TA prognosis has not been well evaluated.

    Methods: We performed a retrospective multicenter review of patients with definite TA who experienced at least one stroke and compared the findings to 17 matched patients with TA diagnosis without neurological involvement. Read More

    Does herpes zoster predispose to giant cell arteritis: a geo-epidemiologic study.
    Clin Ophthalmol 2018 11;12:113-118. Epub 2018 Jan 11.
    Vasculitis Clinic, Rheumatology, Mount Sinai Hospital, Toronto, ON, Canada.
    Purpose: Giant cell arteritis (GCA) is the most common systemic vasculitis in the elderly and can cause irreversible blindness and aortitis. Varicella zoster (VZ), which is potentially preventable by vaccination, has been proposed as a possible immune trigger for GCA, but this is controversial. The incidence of GCA varies widely by country. Read More

    Cross-phenotype analysis of Immunochip data identifiesas a relevantfor the development of systemic vasculitis.
    Ann Rheum Dis 2018 Jan 27. Epub 2018 Jan 27.
    Instituto de Parasitologia y Biomedicina Lopez-Neyra, Granada, Spain.
    Objetive: Systemic vasculitides represent a heterogeneous group of rare complex diseases of the blood vessels with a poorly understood aetiology. To investigate the shared genetic component underlying their predisposition, we performed the first cross-phenotype meta-analysis of genetic data from different clinically distinct patterns of vasculitis.

    Methods: Immunochip genotyping data from 2465 patients diagnosed with giant cell arteritis, Takayasu's arteritis , antineutrophil cytoplasmic antibody-associated vasculitis or IgA vasculitis as well as 4632 unaffected controls were analysed to identify common susceptibilityfor vasculitis development. Read More

    Right orbital edema masquerading a hematologic malignancy.
    SAGE Open Med Case Rep 2018 10;6:2050313X17751838. Epub 2018 Jan 10.
    Division of Hematology/Oncology, Einstein Medical Center, Philadelphia, PA, USA.
    Introduction: Multiple myeloma is caused by abnormal proliferation of plasma cells that affects more commonly African Americans. It classically presents with hypercalcemia, renal failure, anemia, and lytic bone lesions. The aim of this article is to present an unusual case of a 63-year-old African-American female with multiple myeloma who presented with worsening right-sided eye swelling for the past 3 weeks and to briefly review ophthalmologic manifestations of multiple myeloma. Read More

    Imaging giant cell arteritis and Aortitis in contrast enhanced 18F-FDG PET/CT: Which imaging score correlates best with laboratory inflammation markers?
    Eur J Radiol 2018 Feb 27;99:94-102. Epub 2017 Dec 27.
    Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Hoppe-Seyler-Straβe 3, 72076 Tuebingen, Germany. Electronic address:
    Purpose: To define the most appropriate imaging parameters in combined Fluorodeoxyglucose (FDG) PET/CT reflecting the inflammatory burden in large vessel vasculitis.

    Methods: Two readers retrospectively graded disease extent and activity in 17 LVV patients using visual and quantitative scores in FDG PET and contrast enhanced CT. Visual PET scores were assessed corresponding to FDG-uptake vs. Read More

    EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice.
    Ann Rheum Dis 2018 Jan 22. Epub 2018 Jan 22.
    Medical Centre for Rheumatology Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Germany.
    To develop evidence-based recommendations for the use of imaging modalities in primary large vessel vasculitis (LVV) including giant cell arteritis (GCA) and Takayasu arteritis (TAK).European League Against Rheumatism (EULAR) standardised operating procedures were followed. A systematic literature review was conducted to retrieve data on the role of imaging modalities including ultrasound, MRI, CT and [F]-fluorodeoxyglucose positron emission tomography (PET) in LVV. Read More

    Superficial temporal artery aneurysm associated with immunoglobulin G4-related disease.
    J Vasc Surg Cases Innov Tech 2017 Dec 18;3(4):243-246. Epub 2017 Dec 18.
    Department of Pathology, Fukuoka-Higashi Medical Center, Koga, Japan.
    A 68-year-old man was admitted because of a pulsatile mass and pain in the left temporal region, and computed tomography demonstrated the superficial temporal artery aneurysm. He underwent aneurysmectomy, and pathologic investigation revealed marked thickness of the adventitia with substantial plasmacyte infiltration. On immunoglobulin G4 (IgG4) immunohistochemistry, IgG4-positive lymphocytes were scattered in the adventitia, and biochemical tests revealed elevation of IgG4 (200 mg/dL). Read More

    Isolated lower extremity vasculitis leading to progressive critical limb ischemia.
    J Vasc Surg Cases Innov Tech 2017 Sep 17;3(3):119-122. Epub 2017 Jul 17.
    Department of Vascular Surgery, Baylor University Medical Center, Dallas, Tex.
    Giant cell arteritis is a large- and medium-vessel vasculitis that has been described as a systemic disease process with disseminated vessel involvement. Advances in vascular imaging techniques have demonstrated that involvement of the large vessels of the upper and lower limbs may be more prevalent than was once thought, although the clinical implications of this are unknown. Isolated lower extremity claudication without systemic or classic cranial symptoms, especially as a primary manifestation of giant cell arteritis, is rare. Read More

    An immunohistochemical analysis of folate receptor beta expression and distribution in giant cell arteritis - a pilot study.
    Am J Clin Exp Immunol 2017 20;6(6):107-114. Epub 2017 Dec 20.
    Penn State Hershey College of MedicineHershey PA, USA.
    Background: Giant cell arteritis (GCA) is a chronic vasculitis of large and medium vessels in which no targetable biomarkers exist to allow selective treatment, predict disease activity and monitor therapeutic responses. The accessibility of the temporal artery (TA) for biopsy allows morphologic studies to characterize macrophages and T cells in the microenvironment of the arterial wall. We evaluated the expression of folate receptor beta (FRB), a candidate diagnostic/therapeutic biomarker, compared its expression with key macrophage markers and correlated it with GCA severity. Read More

    Giant Cell Arteritis: Practical Pearls and Updates.
    Curr Pain Headache Rep 2018 Jan 17;22(1). Epub 2018 Jan 17.
    Department of Neurology, University of Kentucky, 740 S. Limestone, L445, Lexington, KY, 40536, USA.
    Purpose Of Review: The purpose of this review is to summarize recent updates and distill practical points from the literature which can be applied to the care of patients with suspected and confirmed giant cell arteritis (GCA).

    Recent Findings: Contemporary thinking implicates a fundamental failure of T regulatory cell function in GCA pathophysiology, representing opportunity for novel therapeutic avenues. Tocilizumab has become the first Food and Drug Administration-approved treatment for GCA following demonstration of efficacy and safety in a phase 3 clinical trial. Read More

    Bilateral Non-arteritic Anterior Ischaemic Optic Neuropathy as the Presentation of Systemic Amyloidosis.
    Neuroophthalmology 2017 Dec 19;41(6):330-334. Epub 2017 Jun 19.
    Newcastle Eye Centre, Royal Victoria Infirmary, Newcastle Upon Tyne, United Kingdom.
    A 75-year-old hypertensive female with stable idiopathic intermediate uveitis presented with bilateral sequential optic neuropathy with optic disc swelling. The optic neuropathy in the first affected eye (right) was thought to be due to non-arteritic anterior ischaemic optic neuropathy (NAION). Asymptomatic left optic disc swelling was found at routine review 2 months later, and a diagnosis of giant cell arteritis (GCA) was sought. Read More

    Tocilizumab in Giant Cell Arteritis: A Real-Life Retrospective Study.
    Angiology 2018 Jan 1:3319717753223. Epub 2018 Jan 1.
    1 Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
    This study aims to evaluate (1) the efficacy and safety of tocilizumab (TCZ) as a steroid-sparing agent in patients with giant cell arteritis (GCA) and (2) the usefulness ofF-fluorodeoxyglucose positron emission tomography (FDG-PET) in the follow-up and to detect disease activity. We retrospectively evaluated 12 patients with GCA treated with TCZ (8 mg/kg/mo). Pre- and posttherapy data about clinical signs and symptoms, laboratory results, FDG-PET imaging study, and the mean glucocorticoid (GC) dose were used to assess disease activity. Read More

    [Allergology and clinical immunology].
    Rev Med Suisse 2018 Jan;14(588-589):15-18
    Service d'immunologie et d'allergologie, Département des spécialités de médecine, HUG, 1211 Genève 14.
    Hereditary angioedema (HA) is a disabling and potentially fatal condition. The management of HA includes treatment of acute attacks, short-term prophylaxis to prevent an attack, and long-term prophylaxis to minimize the frequency and severity of recurrent attacks. In this article, we will present new therapeutic alternatives for long term prophylaxis. Read More

    Torsades de Pointes in patients with polymyalgia rheumatica.
    Curr Pharm Des 2018 Jan 10. Epub 2018 Jan 10.
    Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena. Italy.
    Polymyalgia rheumatica (PMR) represents the most common inflammatory rheumatic disease of the elderly. It is characterized by synovitis of proximal joints and extra-articular synovial structures, along with chronic high-grade systemic inflammation. PMR is closely related to giant cell arteritis (GCA), a large-vessel vasculitis that involves the major branches of the aorta, particularly the extracranial branches of carotid artery including temporal arteries. Read More

    Common Primary and Secondary Causes of Headache in the Elderly.
    Headache 2018 Jan 11. Epub 2018 Jan 11.
    Neurological Institute Cleveland Clinic, Cleveland, OH, USA.
    Objective/background: Headache in the elderly, defined as individuals aged 65 and older, although less prevalent than younger individuals, can present as a diagnostic challenge, given the increase in potentially fatal diseases within this population.

    Methods: These individuals require a complete history, neurological examination, and assessment of potential secondary causes of headaches.

    Results: Secondary causes include temporal or giant cell arteritis, subdural hematomas, central nervous system (CNS) tumors, strokes, and CNS infections. Read More

    Risk of fracture among patients with polymyalgia rheumatica and giant cell arteritis: a population-based study.
    BMC Med 2018 01 10;16(1). Epub 2018 Jan 10.
    Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, ST5 5BG, UK.
    Background: Glucocorticoids are associated with increased fracture risk and are the mainstay of treatment in polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). However, fracture risk in these conditions has not been previously quantified. The aim of this study was to quantify the risk of fracture among patients with PMR and GCA. Read More

    Treatment with methotrexate and risk of relapses in patients with giant cell arteritis in clinical practice.
    Clin Exp Rheumatol 2017 Dec 6. Epub 2017 Dec 6.
    Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IDISSC), Hospital Clinico San Carlos, Madrid, Spain.
    Objectives: To assess the incidence and the risk of relapses in giant cell arteritis (GCA) patients treated with and without methotrexate (MTX) in clinical practice. Other associated factors were also investigated.

    Methods: An inception cohort of GCA was assembled in the out-patient clinic at Hospital Clínico San Carlos, including patients from the date of diagnosis (Jan-1991 until Sept-2013), and followed-up until lost of follow up or Sept-2014. Read More

    Serum osteopontin: a biomarker of disease activity and predictor of relapsing course in patients with giant cell arteritis. Potential clinical usefulness in tocilizumab-treated patients.
    RMD Open 2017 22;3(2):e000570. Epub 2017 Dec 22.
    Department of Autoimmune Diseases, Vasculitis Research Unit, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), CRB-CELLEX, Barcelona, Spain.
    Background: Osteopontin (OPN) is a glycoprotein involved in Th1 and Th17 differentiation, tissue inflammation and remodelling. We explored the role of serum OPN (sOPN) as a biomarker in patients with giant cell arteritis (GCA).

    Methods: sOPN was measured by immunoassay in 76 treatment-naïve patients with GCA and 25 age-matched and sex-matched controls. Read More

    Identification of herpes zoster associated temporal arteritis among cases of giant cell arteritis.
    Am J Ophthalmol 2017 Dec 30. Epub 2017 Dec 30.
    Division of Neuro-Ophthalmology, Children's Hospital, University of Iowa, Iowa City, IA.
    Purpose: To examine whether herpes zoster antigen (also called varicella-zoster virus antigen) was detectable in temporal artery biopsies taken from individuals with giant cell arteritis (GCA).

    Design: Retrospective comparative case series.

    Methods: Sections of formalin-fixed paraffin-embedded temporal arteries were examined first by hematoxylin and eosin (H&E) staining to establish the diagnosis of GCA. Read More

    Not Every Case of Temporal Arteritis Is Giant Cell Arteritis. Microscopic Polyangiitis Involving the Temporal Artery: A Case Report and Review of the Literature.
    J Clin Rheumatol 2017 Dec 29. Epub 2017 Dec 29.
    Department of General Internal MedicineUniversity Hospitals LeuvenLeuven, Belgium Department of Microbiology and Immunology KU LeuvenLeuven, Belgium Department of General Internal MedicineUniversity Hospitals LeuvenLeuven, Belgium Department of PathologyUniversity Hospitals LeuvenLeuven, Belgium Department of Microbiology and Immunology KU LeuvenLeuven, Belgium Department of General Internal MedicineUniversity Hospitals LeuvenLeuven, Belgium.

    Spectrum of Aortic Disease in the Giant Cell Arteritis Population.
    Am J Cardiol 2018 Feb 23;121(4):501-508. Epub 2017 Nov 23.
    Mayo Clinic Rochester, Division of Cardiovascular Disease, Rochester, Minnesota. Electronic address:
    We report the spectrum of aortic involvement in patients with giant cell arteritis (GCA) following review of medical records of 4,006 patients including those with imaging studies. A total of 1,450 patients (36%) had a confirmed diagnosis of GCA. Of these, 974 had aortic imaging. Read More

    [A giant cell arteritis revealing a Goodpasture's syndrome].
    Nephrol Ther 2017 Dec 28. Epub 2017 Dec 28.
    Service de médecine interne, centre hospitalier Saint-Joseph-Saint-Luc, 20, quai Claude-Bernard, 69007 Lyon, France.
    Goodpasture's syndrome is a triad of anti-glomerular basement membrane (anti-GBM) circulating antibodies, glomerulonephritis and pulmonary hemorrhage. We reported a 65-year-old woman with headaches, asthenia and weight loss. Giant cell arteritis was confirmed by temporal artery biopsy. Read More

    Large vessel dilatation in giant cell arteritis: a different subset of disease?
    Arthritis Care Res (Hoboken) 2017 Dec 20. Epub 2017 Dec 20.
    Division of Rheumatology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA.
    Objective: To compare patients with large-vessel GCA (LV-GCA) characterized by wall thickening, stenosis and/or occlusion of subclavian arteries to those with subclavian dilatation.

    Methods: For the purposes of the present retrospective study, two different subsets of LV-GCA were identified and compared from an established cohort of patients with radiographic evidence of subclavian artery vasculitis secondary to GCA: 1.LV-GCA with wall thickening, stenosis and/or occlusion of subclavian arteries (Group 1) 2. Read More

    Acute Brachial Radiculoplexopathy and Giant Cell Arteritis.
    Neurologist 2018 Jan;23(1):23-28
    Department of Neurology, Nerve-Muscle Unit.
    Introduction: Giant cell arteritis (GCA), a vasculitis involving large-sized and medium-sized vessels (which most commonly involves temporal arteries), is easily recognized in older patients presenting with headache, scalp tenderness, and raised inflammatory markers. Neurological complications (either central or peripheral) are classically described in GCA.

    Case Report: We report the case of an 85-year-old woman with bilateral acute brachial radiculoplexopathy, a rare neurological complication of GCA. Read More

    MPO-ANCA associated vasculitis with mononeuritis multiplex following influenza vaccination.
    Allergy Asthma Clin Immunol 2017 13;13:49. Epub 2017 Dec 13.
    Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands.
    Background: Although influenza vaccines are generally safe and effective, a variety of autoimmune phenomena have been reported after vaccination over the past years, such as Guillain-Barre syndrome, rheumatoid arthritis, pemphigus vulgaris, psoriasis, giant cell arteritis and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV).

    Case Report: We describe the case of a 67-year old man who presented with a myeloperoxidase-ANCA associated vasculitis with renal involvement and mononeuritis multiplex after seasonal influenza vaccination. He was initially treated with intravenous cyclophosphamide and high-dose prednisolone followed by maintenance treatment consisting of azathioprine and prednisolone. Read More

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