8,563 results match your criteria Temporal Giant Cell Arteritis


Reply to Should Tocilizumab Be Used Routinely in New Patients With a Diagnosis of Giant Cell Arteritis?

J Neuroophthalmol 2022 Jun 22;42(2):e535-e536. Epub 2021 Oct 22.

Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas.

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Approach to Psychiatric Illness in the Rheumatology Clinic.

Curr Rheumatol Rev 2022 May 18. Epub 2022 May 18.

Professor of Medicine, Geisel School of Medicine at Dartmouth.

Rheumatologists encounter psychiatric illness daily in their practice, yet formal training in rheumatology rarely provides instruction in the psychiatric conditions commonly faced. In this article, we review common clinical situations that involve psychiatric disease, their relationship to the rheumatologic condition, how they impact the clinical presentation and their management. We illustrate key principles in a case-based format and reflect on the management of the psychiatric components. Read More

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[Large Vessel Vasculitides: Giant Cell Arteritis and Takayasu Arteritis - Similarities and Differences].

Ther Umsch 2022 Jun;79(5):221-228

Universitätsklinik für Rheumatologie und Immunologie, Inselspital Bern.

Large Vessel Vasculitides: Giant Cell Arteritis and Takayasu Arteritis - Similarities and Differences According to the Chapel Hill Consensus Conference Nomenclature of 2012, giant cell arteritis (GCA) and Takayasu arteritis (TAK) belong to the idiopathic large vessel vasculitides. While GCA is a typical disease of the elderly, TAK begins in adolescence and young adulthood, sometimes even in childhood. In both diseases, immune-mediated granulomatous vascular wall inflammation of the aorta and its major branches leads to the formation of stenoses, occlusions, and aneurysms. Read More

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Abdominal Pain in a Patient With Giant Cell Arteritis.

Cureus 2022 Apr 14;14(4):e24149. Epub 2022 Apr 14.

Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, USA.

Giant cell arteritis (GCA) is a large vessel vasculitis seen in the elderly. It is primarily treated with corticosteroids, which are known to have a multitude of adverse effects, including predisposition to infection and intestinal diverticular perforation. We describe a unique case of a GCA patient with the subtle presentation of acute abdomen. Read More

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Hidden in Plain Sight: Discovering Giant Cell Aortopathy During Surgical Mitral Valve Repair.

JACC Case Rep 2022 May 4;4(9):529-532. Epub 2022 May 4.

DeBakey Heart and Vascular Institute, Houston Methodist Hospital, Houston, Texas, USA.

Giant cell arteritis (GCA) is an inflammatory cranial and/or extracranial vasculitis. Although cranial GCA is widely recognized, extracranial GCA is underdiagnosed because of its nonspecific and atypical presentations. We report a case of asymptomatic extracranial GCA with ascending thoracic aortopathy discovered incidentally during surgical mitral valve repair. Read More

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Tocilizumab for giant cell arteritis.

Cochrane Database Syst Rev 2022 05 13;5:CD013484. Epub 2022 May 13.

Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Denver, Colorado, USA.

Background: Giant cell arteritis (GCA) is the most common form of systemic vasculitis in people older than 50 years of age. It causes granulomatous inflammation of medium- to large-sized vessels. Tocilizumab is a recombinant monoclonal antibody directed against interleukin-6 receptors (IL-6R). Read More

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Ultrasound centre frequency shifts as a novel approach for diagnosing giant cell arteritis.

Scand J Rheumatol 2022 May 13:1-8. Epub 2022 May 13.

Department of Biomedical Engineering, Faculty of Engineering, LTH, Lund University, Lund, Sweden.

Objective: Giant cell arteritis (GCA) is a treatable, but potentially sight- and life-threatening form of systemic vasculitis. Prompt and correct diagnosis is therefore important. Temporal artery biopsy (TAB) is the gold standard for diagnosing GCA, but is associated with risks. Read More

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Subclinical giant cell arteritis in new onset polymyalgia rheumatica A systematic review and meta-analysis of individual patient data.

Semin Arthritis Rheum 2022 Apr 28;55:152017. Epub 2022 Apr 28.

Department of Rheumatology, University Hospital Basel, Basel, Switzerland. Electronic address:

Objectives: To determine the prevalence and predictors of subclinical giant cell arteritis (GCA) in patients with newly diagnosed polymyalgia rheumatica (PMR).

Methods: PubMed, Embase, and Web of Science Core Collection were systematically searched (date of last search July 14, 2021) for any published information on any consecutively recruited cohort reporting the prevalence of GCA in steroid-naïve patients with PMR without cranial or ischemic symptoms. We combined prevalences across populations in a random-effect meta-analysis. Read More

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Large-Vessel Vasculitis in Ophthalmology: Giant Cell Arteritis and Takayasu Arteritis.

Asia Pac J Ophthalmol (Phila) 2022 Mar-Apr 01;11(2):177-183

Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, US.

Abstract: Giant cell arteritis and Takayasu arteritis are large-vessel vasculitides that share multiple common features but also have significant differences in epidemiology, demographics, clinical presentation, evaluation, and treatment. Giant cell arteritis is more common in elderly patients of Caucasian descent versus Takayasu arteritis, which is more prevalent in younger patients of Asian descent. Although traditionally age has been the main criterion for differentiating the 2 etiologies, modifications in the diagnostic criteria have recognized the overlap between the 2 conditions. Read More

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Pericardial effusion in giant cell arteritis is associated with increased inflammatory markers: a retrospective cohort study.

Rheumatol Int 2022 May 7. Epub 2022 May 7.

Assistance Publique des Hôpitaux de Marseille (APHM), Hôpital Nord, Service de Médecine Interne, Aix-Marseille Université (AMU), Marseille, France.

Objective: Giant cell arteritis (GCA) is the most frequent vasculitis affecting adults aged > 50 years. Cardiac involvement in GCA is considered rare, and only a few cases of pericarditis have been reported. The aim of this study was to determine the characteristics and prognosis of GCA patients suffering from pericardial involvement at diagnosis. Read More

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Misdiagnosis of fungal infections of the orbit.

Can J Ophthalmol 2022 May 4. Epub 2022 May 4.

From the Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa. Electronic address:

Objective: To evaluate the accuracy of the initial diagnosis in the case of fungal infections of the orbit and identify factors that may influence patient outcomes.

Methods: An institutional review board-approved retrospective chart review was conducted across 2 large academic centres to identify cases of fungal infections involving the orbit from January 1, 1998, to November 15, 2019. Data collected included patient demographics, past medical history, examination findings, diagnosis, treatment, imaging, and outcomes. Read More

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Diagnostic yield of axillary artery ultrasound in addition to temporal artery ultrasound for the diagnosis of giant cell arteritis.

Clin Exp Rheumatol 2022 May 4;40(4):819-825. Epub 2022 May 4.

Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, Munich, Germany.

Objectives: There are limited data on the additional diagnostic yield of axillary artery ultrasound (axUS) in addition to temporal artery ultrasound (tempUS) for the diagnosis of giant cell arteritis (GCA).

Methods: Retrospective study of consecutive patients with suspected GCA who underwent a standardized axUS and tempUS between 01/2015 and 03/2017. The diagnostic yield of axUS in addition to ultrasound of the temporal arteries with respect to the final clinical diagnosis was assessed, with a positive axUS defined as circumferential, hypoechogenic thickening of the far wall axillary artery intima media thickness (axIMT) ≥1. Read More

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Features and risk factors for new (secondary) permanent visual involvement in giant cell arteritis.

Clin Exp Rheumatol 2022 May 4;40(4):734-740. Epub 2022 May 4.

Department of Internal Medicine, Dupuytren University Hospital, Limoges, France.

Objectives: New permanent visual loss (PVL) in treated patients with giant cell arteritis (GCA) is a rare but worrisome occurrence. In this study, we aimed to describe the frequency and main features of new PVL occurring after the beginning of glucocorticoid therapy in patients with newly diagnosed GCA.

Methods: We included in an inception cohort all consecutive patients newly diagnosed with GCA in the internal medicine department of a tertiary-care hospital between 1976 and May 2020. Read More

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Reply to: Superb microvascular imaging in giant cell arteritis by Conticini et al.

Clin Exp Rheumatol 2022 May 4;40(4):862. Epub 2022 May 4.

Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Italy.

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Giant cell arteritis-related stroke in a large inception cohort: A comparative study.

Semin Arthritis Rheum 2022 Apr 28;55:152020. Epub 2022 Apr 28.

Internal Medicine Department, University Hospital of Limoges, France. Electronic address:

Objective: Stroke caused by giant cell arteritis (GCA) is a rare but devastating condition and early recognition is of critical importance. The features of GCA-related stroke were compared with those of GCA without stroke and atherosclerosis-related or embolic stroke with the aim of more readily diagnosing GCA.

Methods: The study group consisted of 19 patients who experienced GCA-related strokes within an inception cohort (1982-2021) of GCA from the internal medicine department, and the control groups each consisted of 541 GCA patients without a stroke and 40 consecutive patients > 50 years of age with usual first ever stroke from the neurology department of a French university hospital. Read More

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Magnetic resonance imaging-based diagnosis of aortitis preceding development of a thoracic aneurysm in a patient with giant cell arteritis: a case report.

Eur Heart J Case Rep 2022 Apr 12;6(4):ytac152. Epub 2022 Apr 12.

Department of Radiology and Neuroradiology, University Medical Center Schleswig Holstein, Campus Kiel, Kiel, Germany.

Background: Inflammatory manifestation in the aortic arch can be a complication of giant cell arteritis (GCA), potentially requiring surgical therapy in the case of aneurysmatic dilatation.

Case Summary: We report the case of a 73-year-old female patient with GCA in whom a typical appearance of arteritis was visualized on magnetic resonance imaging of the superficial temporal arteries. Additionally, ectasia (4. Read More

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Endovascular Therapy for Intracranial Giant Cell Arteritis : Systematic Review, Technical Considerations and the Effect of Intra-arterial Calcium Channel Blockers.

Clin Neuroradiol 2022 May 3. Epub 2022 May 3.

Department of Radiology and Biomedical Imaging, Interventional Neuroradiology Section, University of California San Francisco, 505 Parnassus Ave, Room L349, 94143, San Francisco, CA, USA.

Background: Giant cell arteritis (GCA) is a systemic vasculitis that may cause ischemic stroke. Rarely, GCA can present with aggressive intracranial stenoses, which are refractory to medical therapy. Endovascular treatment (EVT) is a possible rescue strategy to prevent ischemic complications in intracranial GCA but the safety and efficacy of EVT in this setting are not well-described. Read More

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Aging-Related Vascular Inflammation: Giant Cell Arteritis and Neurological Disorders.

Front Aging Neurosci 2022 12;14:843305. Epub 2022 Apr 12.

Department of Clinical Immunology, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan.

Aging is characterized by the functional decline of the immune system and constitutes the primary risk factor for infectious diseases, cardiovascular disorders, cancer, and neurodegenerative disorders. Blood vessels are immune-privileged sites and consist of endothelial cells, vascular smooth muscle cells, macrophages, dendritic cells, fibroblasts, and pericytes, among others. Aging also termed senescence inevitably affects blood vessels, making them vulnerable to inflammation. Read More

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The glucocorticoid toxicity index: Measuring change in glucocorticoid toxicity over time.

Semin Arthritis Rheum 2022 Apr 15;55:152010. Epub 2022 Apr 15.

Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States.

Glucocorticoids (GCs) have been the cornerstone of treating dozens of inflammatory conditions for more than seven decades. GC toxicity is ubiquitous in both clinical trials and clinical practice, and toxicities associated with GC use are central to the experience of most patients being treated for immune-mediated conditions. These conditions span the full range of medical specialties, including rheumatology, nephrology, gastroenterology, neurology, pulmonology, ophthalmology, and others. Read More

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Man-in-a-barrel syndrome: a rare presentation of giant cell arteritis.

Clin Exp Rheumatol 2022 May 27;40(4):838-840. Epub 2022 Apr 27.

Division of Rheumatology, Department of Internal Medicine, Patras University Hospital, and Department of Medicine, University of Patras Medical School, Rion, Patras, Greece.

We present herein the case of a patient with brachial plexopathy, the first manifestation of giant cell arteritis (GCA). A 71-year-old woman presented with a subacute-onset weakness of her upper extremities; the patient had an initially good clinical response to steroid treatment. However, a few weeks after steroid discontinuation, she manifested fever and fatigue and increased serum markers consistent with a systemic inflammatory response. Read More

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Superb microvascular imaging in giant cell arteritis.

Clin Exp Rheumatol 2022 May 27;40(4):860-861. Epub 2022 Apr 27.

Rheumatology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.

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Does Tocilizumab Influence Ophthalmic Outcomes in Giant Cell Arteritis?

J Neuroophthalmol 2022 Jun 27;42(2):173-179. Epub 2022 Apr 27.

Department of Neurology (MAB), Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Department of Neurology (SP), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts; Department of Medicine (SU), Division of Rheumatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Background: Despite appropriate use of corticosteroids, an important minority of patients with giant cell arteritis (GCA) develop progressive vision loss during the initial stages of the disease or during corticosteroid tapering. Tocilizumab is the only clearly effective adjunctive treatment to corticosteroids in the management of GCA, but questions regarding its efficacy specifically in the neuro-ophthalmic population and its role in mitigating vision loss have not been broached until recently.

Evidence Acquisition: The authors queried Pubmed using the search terms "GCA" and "tocilizumab" in order to identify English-language publications either explicitly designed to evaluate the influence of tocilizumab on the ophthalmic manifestations of GCA or those which reported, but were not primarily focused on, ophthalmic outcomes. Read More

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The Th17 Pathway in Vascular Inflammation: Culprit or Consort?

Front Immunol 2022 11;13:888763. Epub 2022 Apr 11.

Department of Internal Medicine, University of Lyon, Hôpital Edouard Herriot, Lyon, France.

The involvement of IL-17A in autoimmune and inflammatory diseases has prompted the development of therapeutic strategies to block the Th17 pathway. Promising results came from their use in psoriasis and in ankylosing spondylitis. IL-17A acts on various cell types and has both local and systemic effects. Read More

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Calciphylaxis a Giant Cell Arteritis Mimic: A Case Report and Review of the Literature.

J Neuroophthalmol 2022 Mar 18;42(1):e362-e366. Epub 2021 Aug 18.

McGovern Medical School at the University of Texas Health Science Center (AD), Houston, Texas; Department of Ophthalmology (NB, SHB, PC-B, AGL), Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas; Department of Pathology and Genomic Medicine (PC-B), Houston Methodist Hospital, Houston, Texas; Department of Pathology and Laboratory Medicine (PC-B), Weill Medical College of Cornell University, New York, New York; Department of Pathology and Laboratory Medicine (PC-B), the University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Ophthalmology (PC-B, AGL), Baylor College of Medicine. Houston, Texas; The Houston Methodist Research Institute (AGL), Houston Methodist Hospital, Houston, Texas; Departments of Ophthalmology Weill Cornell Medicine (AGL), New York, New York; Department of Ophthalmology (AGL), University of Texas Medical Branch, Galveston, Texas; University of Texas MD Anderson Cancer Center (AGL), Houston, Texas; Texas A and M College of Medicine (AGL), Bryan, Texas; and Department of Ophthalmology (AGL), the University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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Treatment and Outcomes of Acute Myocardial Infarction in Patients With Polymyalgia Rheumatica With and Without Giant Cell Arteritis.

Am J Cardiol 2022 Apr 23. Epub 2022 Apr 23.

Keele Cardiovascular Research Group, Center for Prognosis Research, Keele University, United Kingdom; Department of Cardiology, Royal Stoke University Hospital, Stoke-on-Trent, United Kingdom. Electronic address:

This study analyzed the characteristics, management, and outcomes of patients with polymyalgia rheumatica (PMR) hospitalized with acute myocardial infarction (AMI), including sensitivity analysis for presence of giant cell arteritis (GCA). Using the National Inpatient Sample (January 2004 to September 2015) and International Classification of Diseases, Ninth Revision, all AMI hospitalizations were stratified into main groups: PMR and no-PMR; and subsequently, PMR, PMR with GCA, and GCA and no-PMR. Outcomes were all-cause mortality, major adverse cardiovascular/cerebrovascular events (MACCEs), major bleeding, and ischemic stroke as well as coronary angiography (CA) and percutaneous coronary intervention (PCI). Read More

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Phenotypic, transcriptomic and functional profiling reveal reduced activation thresholds of CD8+ T cells in giant cell arteritis.

Rheumatology (Oxford) 2022 Apr 23. Epub 2022 Apr 23.

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

Objective: Evidence from temporal artery tissue and blood suggests involvement of CD8+ T cells in the pathogenesis of giant cell arteritis (GCA), but their exact role is poorly understood. Therefore, we performed a comprehensive analysis of circulating and lesional CD8+ T cells in GCA patients.

Methods: Circulating CD8+ T cells were analysed for differentiation status (CD45RO, CCR7), markers of activation (CD69 and CD25) and proliferation (Ki-67) in 14 newly diagnosed GCA patients and 18 healthy controls by flow cytometry. Read More

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Validity of Machine Learning in Predicting Giant Cell Arteritis Flare After Glucocorticoids Tapering.

Front Immunol 2022 5;13:860877. Epub 2022 Apr 5.

Department of Emergency and Organ Transplantation, Rheumatology Unit, University of Bari, Bari, Italy.

Background: Inferential statistical methods failed in identifying reliable biomarkers and risk factors for relapsing giant cell arteritis (GCA) after glucocorticoids (GCs) tapering. A ML approach allows to handle complex non-linear relationships between patient attributes that are hard to model with traditional statistical methods, merging them to output a forecast or a probability for a given outcome.

Objective: The objective of the study was to assess whether ML algorithms can predict GCA relapse after GCs tapering. Read More

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Lateral rectus muscle palsy secondary to sphenoid sinusitis.

Authors:
W S Leong O Mulla

Ann R Coll Surg Engl 2022 Apr 21. Epub 2022 Apr 21.

Doncaster and Bassetlaw Hospitals NHS Foundation Trust, UK.

Isolated sphenoid sinus disease is a rare, often misdiagnosed condition of the paranasal sinus. If left untreated, it can lead to complications involving pituitary gland, cavernous sinus, neurological and vascular structures nearby. Early recognition and treatment are critical to prevent the progression of the disease. Read More

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Corticosteroids reduce vascular ultrasound sensitivity in fast- track pathways (FTP): results from Coventry Multi-Disciplinary FTP for cranial Giant Cell Arteritis.

Scand J Rheumatol 2022 Apr 20:1-10. Epub 2022 Apr 20.

Deptartment of Rheumatology, University Hospital Coventry and Warwickshire NHS Trust, Coventry, UK.

Objectives: This study aims to assess the feasibility of the Coventry multidisciplinary fast-track cranial giant cell arteritis (FTGCA) pathway, which was set up in 2013 in collaboration with vascular physiology and ophthalmology to enable prompt multidisciplinary assessment, including ultrasound (US). This study also looks at the impact of prior corticosteroid (CS) use on the performance of US in real life.

Method: Data were collected retrospectively for patients who attended the Coventry FTGCA pathway between 1 January 2014 and 31 December 2017. Read More

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Giant Cell Arteritis Masquerading as Orbital Inflammatory Disease.

J Neuroophthalmol 2022 Apr 19. Epub 2022 Apr 19.

Save Sight Institute, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney (JYT), Sydney, Australia; Clinpath Laboratories (CJ), Adelaide, South Australia, Australia; Department of Medical Imaging, Royal Adelaide Hospital (SP), Adelaide, South Australia, Australia; and Discipline of Ophthalmology and Visual Sciences (DS), The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide, Australia.

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