Difference in the expression of IL-9 and IL-17 correlates with different histological pattern of vascular wall injury in giant cell arteritis

Giant cell arteritis may lead to catastrophic, large-vessel complications from chronic vascular wall inflammation without prompt diagnosis and treatment. We describe a rare case of acute aortic dissection without preceding aneurysm secondary to histologically confirmed giant cell arteritis (GCA) in an 85-year-old female with a four-year history of polymyalgia rheumatica and temporal arteritis diagnosed per biopsy six months prior to presentation. The literature is reviewed and the clinical implications of this case are discussed.

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OP0281 Survival of Biopsy-Proven Giant Cell Arteritis in Italy during A 26-Year Period: Correlation with Histological Pattern

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2016-eular.3979 ◽

2016 ◽

Vol 75 (Suppl 2) ◽

pp. 164.2-164

Author(s):

P. Macchioni ◽

L. Boiardi ◽

M. Catanoso ◽

F. Muratore ◽

A. Cavazza ◽

...

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Histological Pattern

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Possibilities of Magnetic Resonance Imaging in the Diagnosis of Changes in the «Vascular Wall» in Giant Cell Arteritis

Radiology - Practice ◽

10.52560/2713-0118-2021-2-25-40 ◽

2021 ◽

pp. 25-40

Author(s):

T. A. Lesnykh ◽

M. A. Kravchenko ◽

R. N. Konovalov ◽

M. V. Dreval' ◽

M. V. Krotenkova ◽

...

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Vessel Wall ◽

Ultrasound Examination ◽

Vascular Wall ◽

Layer By Layer ◽

Vertebral Arteries ◽

Layer Analysis ◽

Wall Components ◽

Carotid And Vertebral Arteries

The aim of the study: to identify features of extracranial carotid and vertebral arteries vessel wall MRI in norm and pathology using layer-by-layer analysis of the arterial wall components. MRI results were compared at the same anatomical level with data of ultrasound examination of vertebral arteries in patients with giant cell arteritis and in health individuals. It was revealed that in normal arteries MRI signal from the vessel wall mainly formed by vascularized adventitia and venous plexuses. Media and intima visualization becomes possible in cases of their pathological transformation. Thus, it was defined which structures of the vessel wall take part in MRI signal forming in health individuals and patient with pathology. Also MRI patterns of different stages of large arteries vasculitis were identified.

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Nagyérvasculitisek korszerű kezelése

Orvosi Hetilap ◽

10.1556/650.2017.30630 ◽

2017 ◽

Vol 158 (1) ◽

pp. 5-12

Author(s):

Melinda Zsuzsanna Szabó ◽

Emese Kiss

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Takayasu Arteritis ◽

Significant Proportion ◽

Vascular Wall ◽

Good Choice ◽

Large Vessel ◽

Necrosis Factor Alpha ◽

Factor Alpha ◽

Large Vessel Vasculitides

Abstract: Giant cell arteritis and Takayasu arteritis classified to large vessel vasculitides have similar histopathology in the vascular wall proposing that these entities can be different phenotypes on a spectrum of a single disorder. Glucocorticoids are the mainstay of therapy combined with cyclophosphamide, azatioprine and mycofenolate mofetil, when it is required. However, a significant proportion of patients are glucocorticoid-dependent despite of the conventional disease-modifying antirheumatic drugs and suffer from serious side effects of the steroids, therefore alternate options for more effective disease management are needed. The article reviews the advances in the treatment of large vessel vasculitides. Tumor necrosis factor-alpha inhibitors seem to be effective in Takayasu arteritis, but have a little benefit in giant cell arteritis. Interleukin-6 inhibitor appears very promising in both refractory giant cell arteritis and Takayasu arteritis as well. Abatacept and ustekinumab also seem to be a good choice for the therapy. Orv. Hetil., 2017, 158(1), 5–12.

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Arterial wall injury in giant cell arteritis

Arthritis & Rheumatism ◽

10.1002/1529-0131(199905)42:5<844::aid-anr2>3.0.co;2-m ◽

1999 ◽

Vol 42 (5) ◽

pp. 844-853 ◽

Cited By ~ 110

Author(s):

Cornelia M. Weyand ◽

J�rg J. Goronzy

Keyword(s):

Giant Cell Arteritis ◽

Giant Cell ◽

Arterial Wall ◽

Arterial Wall Injury ◽

Wall Injury

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Large-Vessel Vasculitis: Interobserver Agreement and Diagnostic Accuracy of18F-FDG-PET/CT

BioMed Research International ◽

10.1155/2015/914692 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 23

Author(s):

K. D. F. Lensen ◽

E. F. I. Comans ◽

A. E. Voskuyl ◽

C. J. van der Laken ◽

E. Brouwer ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Fdg Pet ◽

Interobserver Agreement ◽

External Validation ◽

Vascular Wall ◽

Fdg Uptake ◽

Pet Ct ◽

Fdg Pet Ct

Introduction.18F-FDG-PET visualises inflammation. Both atherosclerosis and giant cell arteritis cause vascular inflammation, but distinguishing the two may be difficult. The goal of this study was to assess interobserver agreement and diagnostic accuracy of18F-FDG-PET for the detection of large artery involvement in giant cell arteritis (GCA).Methods. 3118F-FDG-PET/CT scans were selected from 2 databases. Four observers assessed vascular wall18F-FDG uptake, initially without and subsequently with predefined observer criteria (i.e., vascular wall18F-FDG uptake compared to liver or femoral artery18F-FDG uptake). External validation was performed by two additional observers. Sensitivity and specificity of18F-FDG-PET were determined by comparing scan results to a consensus diagnosis.Results. The highest interobserver agreement (kappa: 0.96 in initial study and 0.79 in external validation) was observed when vascular wall18F-FDG uptake higher than liver uptake was used as a diagnostic criterion, although agreement was also good without predefined criteria (kappa: 0.68 and 0.85). Sensitivity and specificity were comparable for these methods. The criterion of vascular wall18F-FDG uptake equal to liver18F-FDG uptake had low specificity.Conclusion. Standardization of image assessment for vascular wall18F-FDG uptake promotes observer agreement, enables comparative studies, and does not appear to result in loss of diagnostic accuracy compared to nonstandardized assessment.

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