Polymyalgica rheumatica and giant cell arteritis

2008 ◽  
Vol 18 (2) ◽  
pp. 91-101 ◽  
Author(s):  
H A Bird ◽  
Helen Mac Iver
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Visual Loss ◽  
Temporal Arteritis ◽  
Morning Stiffness ◽  
Temporal Artery ◽  
Shoulder Girdle ◽  
Pelvic Girdle ◽  
Disease Spectrum

Polymyalgia rheumatica and giant cell arteritis are closely related conditions, considered by many to represent opposite poles of a single disease spectrum. They can occur together or separately.Polymyalgia rheumatica is characterized by pain and morning stiffness in the shoulder girdle and sometimes the pelvic girdle. The symptoms are felt to be related to synovitis of proximal joints and extra-articular synovial structures. Giant cell arteritis displays a frank vasculitis affecting the regions supplied by the temporal artery to give visual loss and scalp tenderness but is increasingly recognized to also affect the aorta and its extra-cranial branches. For this reason the term ‘giant cell arteritis’, which is descriptive of the pathology, is used instead of the alternative term ‘temporal arteritis’, which gives a misleading impression of localization but which was the term used in previous reviews for this journal, the most recent in 2003.

Polymyalgia rheumatica and temporal arteritis

2010 ◽  
pp. 3678-3683
Author(s):  
Jan Tore Gran
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Histological Examination ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Superficial Temporal Artery ◽  
Granulomatous Inflammation ◽  
Temporal Artery ◽  
Unknown Aetiology ◽  
Inflammatory Conditions

Polymyalgia rheumatica and temporal arteritis are distinct but overlapping inflammatory conditions of unknown aetiology. They almost exclusively affect people over 50 years of age, women more than men (ratio 2–3:1), and particularly those of Nordic heritage. Temporal arteritis is characterized by granulomatous inflammation that penetrates all layers of the wall of medium and (often) large muscular arteries, in particular the superficial temporal artery. Histological examination of tissues from patients with polymyalgia rheumatica shows nonspecific changes only. The term ‘giant cell arteritis’ is properly used only to describe patients with biopsy-proven arteritis....

scholarly journals Polymialgia Rheumatica, Giant Cell Arteritis or Both?

2018 ◽  
Vol 15 (6) ◽  
pp. 51-58
Author(s):  
Adina Cociorvei ◽  
Mădălina Ababei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Arteritis ◽  
Morning Stiffness ◽  
Systemic Vasculitis ◽  
Diagnostic Algorithm ◽  
Signs And Symptoms ◽  
Temporal Artery ◽  
Clinical Suspicion ◽  
Temporal Artery Biopsy

AbstractGiant cell arteritis (GCA), or temporal arteritis, is the most common systemic vasculitis, and the greatest risk factor for developing GCA is aging. The disease almost never occurs before age 50, and its incidence rises steadily thereafter, peaking between ages 70 to 79, the risk of development being two times higher in women.Polymialgia rheumatica (PMR) is an inflammatory rheumatic condition characterized clinically by aching and morning stiffness at the shoulders, hip girdle, and neck. PMR is almost exclusively a disease of adults over the age of 50, with a prevalence that increases progressively with advancing age. The peak incidence of PMR occurs between ages 70 and 80, the same as in the case ofGCA. PMRis 2-3 times more common in women than in men.PMR is two to three times more common than GCA and occurs in about 50% of patients with GCA. The percentage of patients with PMR who experience GCA at some point varies widely in reported series ranging from 5 to 30 percent. PMR can precede, accompany or follow GCA. The diagnostic in the case of PMR is made first of all on clinical features, in the patients in whom another disease to explain the findings is not present. For GCA we must follow the diagnostic algorithm presented below (figure 1) and keep in mind that a negative result for temporal artery biopsy does not exclude the diagnostic if clinical suspicion of GCA is highWe present the case of a 81 year-old male with signs and symptoms from both conditions, PMR and GCA.

Polymyalgia rheumatica and giant cell arteritis

2013 ◽  
Vol 6 (3) ◽  
pp. 155-158
Author(s):  
Azeem A. Ahmed
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Visual Loss ◽  
Disease Onset ◽  
Shoulder Girdle ◽  
Clinical Suspicion ◽  
Current Evidence ◽  
Evidence Based ◽  
Significant Morbidity

Polymyalgia rheumatica is an inflammatory condition characterised by pain and stiffness in the neck, shoulder girdle and pelvic girdle. Giant cell arteritis is a vasculitis involving large and medium vessels. Both disorders affect patients over the age of 50. Both disorders are characterised by an inflammatory response and respond to corticosteroid therapy. They are self-limiting disorders that settle after two to three years from disease onset. Giant cell arteritis is a major cause of irreversible visual loss. Ophthalmic complications can occur in up to 30% of patients. Significant morbidity can result from corticosteroid side-effects which remains the cornerstone of therapy. This article aims to highlight the current evidence-based management of polymyalgia rheumatica and giant cell arteritis from clinical suspicion to treatment.

Polymyalgia Rheumatica - a Disease of the Elderly

2018 ◽  
Vol 69 (1) ◽  
pp. 152-154
Author(s):  
Vasilica Cristescu ◽  
Aurelia Romila ◽  
Luana Andreea Macovei
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Temporal Arteritis ◽  
Viral Infections ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Clinical Aspects ◽  
Immune Disorder ◽  
Markers Of Inflammation

Polymyalgia rheumatica is a disease that occurs mostly in the elderly and is rarely seen in patients less than 50 years of age. Polymyalgia rheumatica is a vasculitis, which manifests itself as an inflammatory disease of the vascular wall that can affect any type of blood vessel, regardless of its size. It has been considered a form of giant cell arteritis, involving primarily large and medium arteries and to a lesser extent the arterioles. Clinical manifestations are caused by the generic pathogenic process and depend on the characteristics of the damaged organ. PMR is a senescence-related immune disorder. It has been defined as a stand-alone condition and a syndrome referred to as rheumatic polyarteritis with manifestations of giant cell arteritis (especially in cases of Horton�s disease and temporal arteritis) which are commonly associated with polymyalgia. The clinical presentation is clearly dominated by the painful girdle syndrome, with a feeling of general discomfort. Polymyalgia and temporal arteritis may coexist or be consecutive to each other in the same patient, as in most of our patients. The present study describes 3 cases of polymyalgia rheumatica, admitted to the Clinic of Rheumatology of Sf. Apostol Andrei Hospital, Galati. The cases were compared with the literature. Two clinical aspects (polymyalgia rheumatica and/or Horton�s disease) and the relationship between them were also considered. Polymyalgia rheumatica is currently thought to have a multifactorial etiology, in which the following factors play a role: genetic factors or hereditary predisposition (some individuals are more prone to this disease), immune factors and viral infections (triggers of the disease). Other risk factors of polymyalgia rheumatica include age over 50 years and the association with giant cell arteritis. The characteristic feature of the disease is girdle pain, with intense stiffness of at least one hour�s duration. Markers of inflammation, erythrocyte sedimentation rate and C-reactive protein are almost always increased at the onset of the disease. Diseases that can mimic the clinical picture of polymyalgia rheumatica are neoplasia, infections, metabolic disorders of the bone and endocrine diseases.

–463 G/A myeloperoxidase promoter polymorphism in giant cell arteritis

2007 ◽  
Vol 67 (4) ◽  
pp. 485-488 ◽  
Author(s):  
C Salvarani ◽  
B Casali ◽  
E Farnetti ◽  
N Pipitone ◽  
D Nicoli ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Clinical Features ◽  
Polymyalgia Rheumatica ◽  
Visual Loss ◽  
Geographic Area ◽  
Population Based ◽  
Promoter Polymorphism ◽  
Reggio Emilia ◽  
Cerebrovascular Accidents

Objective:To investigate potential associations between–463 G/A myeloperoxidase (MPO) promoter polymorphism and susceptibility to, and clinical features of giant cell arteritis (GCA).Methods:A total of 156 patients with biopsy-proven GCA who were residents of Reggio Emilia, Italy, and 235 population-based controls from the same geographic area were genotyped for–463 G/A promoter polymorphism of the MPO gene by molecular methods. The patients were subgrouped according to the presence or absence of polymyalgia rheumatica and severe ischaemic complications (visual loss and/or cerebrovascular accidents).Results:The distribution of the MPO-G/A genotype differed significantly between patients with GCA and the controls (pcorr = 0.003). Allele G was significantly more frequent in patients with GCA than in the controls (pcorr = 0.0002, OR 2.0, 95% CI 1.4 to 2.9). Homozygosity for the G allele was significantly more frequent in patients with GCA than in controls (pcorr = 0.0002, OR 2.2, 95% CI 1.4 to 3.4). No significant associations were found when patients with GCA with and without polymyalgia rheumatica or with and without severe ischaemic complications were compared.Conclusions:Our findings show that the–463 G/A promoter polymorphism of the MPO gene is associated with GCA susceptibility and support a role for MPO in the pathophysiology of GCA.

scholarly journals Clinical implication of FDG-PET/CT in monitoring disease activity in large-vessel giant cell arteritis linked with secondary polymyalgia rheumatica

2014 ◽  
Vol 1 (1) ◽  
pp. 6 ◽  
Author(s):  
Yoshinori Taniguchi ◽  
Shuichi Nakayama ◽  
Yoshio Terada
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Fdg Pet ◽  
Pelvic Girdle ◽  
Large Vessel ◽  
Pelvic Girdle Pain ◽  
Low Grade ◽  
Pet Ct ◽  
Fdg Pet Ct

Seventy year-old female presented low-grade fever, neck and pelvic girdle pain, jaw claudication and pulseless without visual disturbance. Laboratory examinations showed that C-reactive protein and erythrocyte sedimentation rate (ESR) were 11 mg/dl and 123 mm/1hr, respectively. FDG-PET/CT findings demonstrated bilateral subclavian, carotid and femoral arteritis and aortitis in addition to bursitis and enthesitis of spinous process and pelvic girdle. We diagnosed as large-vessel giant cell arteritis (GCA) linked with secondary polymyalgia rheumatica (PMR). Glucocorticoid therapy was started, and not only these symptoms and but also abnormal findings of FDG-PET/CT were improved.

scholarly journals Scalp Necrosis Revealing Severe Giant-Cell Arteritis

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Safa Idoudi ◽  
Marouene Ben Kahla ◽  
Fares Mselmi ◽  
Badreddine Sriha ◽  
A. Guiga ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Carotid Arteries ◽  
Temporal Arteritis ◽  
Temporal Artery ◽  
The Elderly ◽  
Rare Occurrence ◽  
Irreversible Loss ◽  
Scalp Necrosis ◽  
Primary Vasculitis

Giant-cell arteritis (GCA), also referred to as temporal arteritis, is the most common primary vasculitis of the elderly involving the extracranial branches of the carotid arteries, in particular, the temporal artery. Patients usually present with temporal headaches, visual impairment, fever, and scalp tenderness. Scalp necrosis associated with GCA is a rare occurrence with approximately 100 cases reported in the literature to date. It is a therapeutic emergency requiring urgent management as it may lead to irreversible loss of vision. To increase awareness of this severe complication, we report a patient with a scalp necrosis revealing a GCA.

Giant cell arteritis: advances in diagnosis and management

2019 ◽  
Vol 80 (8) ◽  
pp. 448-455
Author(s):  
Mehdi Raza ◽  
Yasser El Maideny ◽  
Nadia Bokhari
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Biological Therapies ◽  
Diagnosis And Management ◽  
American College Of Rheumatology ◽  
The World ◽  
Cranial Vessels

Giant cell arteritis has been widely studied throughout the world. Involvement of cranial vessels can lead to visual loss and strokes. This review primarily focusses on the presentation, diagnosis and treatment. The last 10 years have brought dramatic improvements in the imaging and medical therapies for this condition. After the American College of Rheumatology suggested criteria for the diagnosis of giant cell arteritis, many studies have been performed to find alternatives to a temporal artery biopsy. There is growing evidence that a biopsy may not be needed when one can make a convincing clinical and radiological diagnosis. Although glucocorticoids are the mainstay of treatment and their role has not changed, various biological and non-biological therapies are being used to reduce relapses and prolong remission of symptoms.

Sign in / Sign up

Export Citation Format

Share Document