scholarly journals Giant Cell Arteritis: An Atypical Presentation Diagnosed with the Use of MRI Imaging

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Siddesh Shambhu ◽  
Lisbet Suarez
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Systemic Vasculitis ◽  
Mri Imaging ◽  
Primary Systemic Vasculitis ◽  
Ischemic Complications ◽  
Granulomatous Involvement ◽  
Atypical Presentations ◽  
Upper Abdominal ◽  
First Time

Giant cell arteritis (GCA) is the most common primary systemic vasculitis in western countries in individuals over the age of 50. It is typically characterised by the granulomatous involvement of large and medium sized blood vessels branching of the aorta with particular tendencies for involving the extracranial branches of the carotid artery. Generally the diagnosis is straightforward when characteristic symptoms such as headache, jaw claudication, or other ischemic complications are present. Atypical presentations of GCA without “overt” cranial ischemic manifestations have become increasingly recognised but we report for the first time a case of GCA presenting as mild upper abdominal pain and generalized weakness in the context of hyponatremia as the presenting manifestation of vasculitis that was subsequently diagnosed by MRI scanning. This case adds to the literature and emphasises the importance of MRI in the evaluation of GCA patients without “classic” cranial ischemic symptoms.

scholarly journals Challenges in the Diagnosis of Giant Cell Arteritis Before Visual Loss

2020 ◽  
pp. 1-5
Author(s):  
Purnima Mehta ◽  
Faaiq Hassan ◽  
Muhammed Omar Qadir ◽  
Shirish Dubey ◽  
Sergio Pagliarini ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Visual Loss ◽  
Systemic Vasculitis ◽  
The Elderly ◽  
Common Type ◽  
Atypical Presentation ◽  
Delay In Diagnosis ◽  
Atypical Presentations ◽  
High Index Of Suspicion

Background: Giant cell arteritis (GCA) is the most common type of systemic vasculitis affecting the elderly. Ophthalmic presentations of GCA in particular can be difficult to identify prior to permanent visual loss occurring. Methods: Here, we present 3 challenging cases as a retrospective series to highlight the variable presentations of GCA with ophthalmic involvement, but GCA was not suspected due to atypical presentation. Results: Unfortunately, all 3 cases went on to develop visual loss in the affected eye due to a delay in diagnosis or treatment. The authors wish to highlight the challenges posed to the referring clinicians, when patients had systemic/ocular co-morbidities, which delayed the suspicion of GCA Conclusion with a Practical Point: Our cases highlight the variable presentations of this condition as well as the devastating ophthalmic implications that GCA can have. A high index of suspicion must be maintained; particularly in elderly patients with atypical presentations.

Lack of Association Between IRF5 Gene Polymorphisms and Biopsy-proven Giant Cell Arteritis

2009 ◽  
Vol 37 (1) ◽  
pp. 136-140 ◽  
Author(s):  
ORLANDO TORRES ◽  
ROGELIO PALOMINO-MORALES ◽  
TOMAS R. VAZQUEZ-RODRIGUEZ ◽  
SANTOS CASTAÑEDA ◽  
INMACULADA C. MORADO ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymerase Chain Reaction Amplification ◽  
Gene Variants ◽  
Genotype Distribution ◽  
Genotype Frequencies ◽  
Ischemic Complications ◽  
Reaction Amplification ◽  
Polymerase Chain ◽  
First Time

Objective.Interferon (IFN) regulatory factors (IRF) are transcriptional mediators of IFN-induced signaling pathways and are involved in immune response. We have analyzed for the first time the association of 2 IRF5 gene variants in the susceptibility to giant cell arteritis (GCA).Methods.Two hundred twenty patients with biopsy-proven GCA and 520 matched controls were assessed. DNA from patients and controls was obtained from peripheral blood. Samples were genotyped for the IRF5 rs2004640 and for the IRF5 CGGGG insertion/deletion polymorphism using a predesigned TaqMan allele discrimination assay and by polymerase chain reaction amplification, followed by an ABI3100 sequencer, respectively.Results.A genotyping rate of 96% was achieved in this series of GCA patients. No significant differences were found in the genotype distribution between GCA patients and controls for both IRF5 gene variants. In this regard, similar genotype frequencies were found in GCA patients and controls. No significant differences were observed when GCA patients were stratified according to the presence of specific clinical features of the disease such as polymyalgia rheumatica or severe ischemic complications.Conclusion.Our results showed no association of IRF5 rs2004640 and CGGGG insertion/deletion polymorphisms in the susceptibility to and clinical expression of GCA.

scholarly journals Cellular and Molecular Characteristics of Vascular Damage in Giant Cell Arteritis, the ‘Unmet Needs’ for Targeted Treatment

2021 ◽  
Author(s):  
Luiza Rusu
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Systemic Inflammation ◽  
Systemic Vasculitis ◽  
Corticosteroid Treatment ◽  
Cardiovascular Complications ◽  
Vascular Damage ◽  
Molecular Characteristics ◽  
Arterial Lumen ◽  
Primary Systemic Vasculitis

Giant cell arteritis (GCA) is a primary systemic vasculitis characterized by systemic inflammation and vascular insufficiency of large and medium blood vessels which may lead to end-organ damage in patients age 50 and older. Standard corticosteroid treatment of GCA significantly improves the intima-media thickness while having less influence on vascular endothelial dysfunction. GCA morbidity may be related to both cardiovascular complications and corticosteroid toxicity. Therefore, we aim to discuss 1) characteristic aspects of vascular damage, 2) several mechanisms that cause vascular dysfunction, intima-media ‘nodular’ thickness, progressive narrowing of the arterial lumen and vascular blockage in the context of systemic inflammation, thrombosis and of the cardiovascular complications in GCA and 3) new therapeutic glucocorticosteroid-sparing (GS) agents which might be a more productive way of avoiding the invalidating or life-threatening cardiovascular complications of GCA.

Role of rs1343151 IL23R and rs3790567 IL12RB2 Polymorphisms in Biopsy-proven Giant Cell Arteritis

2011 ◽  
Vol 38 (5) ◽  
pp. 889-892 ◽  
Author(s):  
LUIS RODRÍGUEZ-RODRÍGUEZ ◽  
FRANCISCO D. CARMONA ◽  
SANTOS CASTAÑEDA ◽  
JOSÉ A. MIRANDA-FILLOY ◽  
INMACULADA C. MORADO ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymerase Chain Reaction Amplification ◽  
Phenotypic Expression ◽  
Minor Allele ◽  
Potential Association ◽  
Ischemic Complications ◽  
Reaction Amplification ◽  
Polymerase Chain

Objective.To assess the potential association between the rs1343151 IL23R and the rs3790567 IL12RB2 polymorphisms and giant cell arteritis (GCA). We also studied whether these polymorphisms might influence the phenotypic expression of GCA.Methods.In total, 357 Spanish patients with biopsy-proven GCA and 574 matched controls were assessed. DNA from patients and controls was obtained from peripheral blood. Samples were genotyped for the rs1343151 IL23R and the rs3790567 IL12RB2 polymorphisms using a predesigned TaqMan allele discrimination assay and by polymerase chain reaction amplification.Results.Regarding the rs1343151 IL23R polymorphism, no significant differences in the genotype or allele frequencies between GCA patients and healthy controls were observed. The frequency of the minor allele A of the rs3790567 IL12RB2 variant was increased in GCA patients compared with controls (30.1% vs 25.7%, respectively; p = 0.039, OR 1.25, 95% CI 1.01–1.54). An increased frequency of subjects carrying the minor allele A (GA+AA genotypes) of the rs3790567 IL12RB2 polymorphism was found among GCA patients compared with controls (52.8% vs 44.4%; p = 0.013, OR 1.40, 95% CI 1.06–1.85). Although a higher frequency of the combination of minor alleles (A-A) in the subgroup of patients with visual ischemic complications compared with the combination of both major alleles (G-G; p = 0.029) or with the other allelic combinations (p = 0.035) was found, logistic regression analysis showed that this association was no longer significant after adjustment for potential confounding factors (A-A vs G-G: OR 2.10, 95% CI 0.88–5.04, p = 0.096).Conclusion.Our results support a potential influence of the rs3790567 IL12RB2 polymorphism in the pathogenesis of GCA.

scholarly journals Tissue and Serum Angiogenic Activity Is Associated With Low Prevalence of Ischemic Complications in Patients With Giant-Cell Arteritis

Circulation ◽  
2002 ◽  
Vol 106 (13) ◽  
pp. 1664-1671 ◽  
Author(s):  
Maria C. Cid ◽  
José Hernández-Rodríguez ◽  
María-José Esteban ◽  
Mireia Cebrián ◽  
Yong Song Gho ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Angiogenic Activity ◽  
Ischemic Complications ◽  
Low Prevalence

Lack of Association Between STAT4 Gene Polymorphism and Biopsy-proven Giant Cell Arteritis

2009 ◽  
Vol 36 (5) ◽  
pp. 1021-1025 ◽  
Author(s):  
ROGELIO PALOMINO-MORALES ◽  
TOMAS R. VAZQUEZ-RODRIGUEZ ◽  
INMACULADA C. MORADO ◽  
SANTOS CASTAÑEDA ◽  
NORBERTO ORTEGO-CENTENO ◽  
...  
Keyword(s):  
Gene Polymorphism ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Statistical Significance ◽  
Clinical Manifestations ◽  
Clinical Expression ◽  
Potential Implication ◽  
Genotype Frequencies ◽  
Ischemic Complications

Objective.To investigate the potential implication of the STAT4 gene polymorphism rs7574865 in the predisposition to or the clinical expression of giant cell arteritis (GCA).Methods.A total of 212 patients diagnosed with biopsy-proven GCA were studied. DNA from patients and controls matched by age, sex, and ethnicity was obtained from peripheral blood. Samples were genotyped for STAT4 rs7574865 polymorphism.Results.No statistically significant differences in the allele frequencies for the STAT4 rs7574865 polymorphism were observed between patients and controls. Although we observed an increased frequency of the T/T genotype in GCA patients (6.0%) compared to healthy controls (3.9%), this difference did not achieve statistical significance (OR 1.57, 95% CI 0.72–3.41). No statistically significant differences in allele or genotype frequencies were observed when patients were stratified according to the presence of typical disease features such as polymyalgia rheumatica, severe ischemic manifestations, and visual ischemic complications in the setting of this vasculitis.Conclusion.Our results do not support a major role of the STAT4 rs7574865 gene polymorphism in susceptibility to or clinical manifestations of GCA.

Prevalence of ischemic complications in patients with giant cell arteritis presenting with apparently isolated polymyalgia rheumatica

2015 ◽  
Vol 45 (3) ◽  
pp. 328-333 ◽  
Author(s):  
Javier Narváez ◽  
Paula Estrada ◽  
Laura López-Vives ◽  
Milagros Ricse ◽  
Andrea Zacarías ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Polymyalgia Rheumatica ◽  
Ischemic Complications

Influence of Traditional Risk Factors of Atherosclerosis in the Development of Severe Ischemic Complications in Giant Cell Arteritis

Medicine ◽  
2004 ◽  
Vol 83 (6) ◽  
pp. 342-347 ◽  
Author(s):  
Miguel A. Gonzalez-Gay ◽  
Angela Piñeiro ◽  
Adriana Gomez-Gigirey ◽  
Carlos Garcia-Porrua ◽  
Robustiano Pego-Reigosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Ischemic Complications ◽  
Traditional Risk Factors

scholarly journals Arteritis temporalis

2009 ◽  
Vol 18 (1) ◽  
Author(s):  
Øyvind Palm
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Systemic Vasculitis ◽  
Temporal Artery ◽  
Annual Incidence ◽  
High Incidence ◽  
Arteritis Temporalis

Giant cell arteritis (GCA) is a common systemic vasculitis in elderly Norwegian patients. Scandinavian studies confirm that GCA usually starts rather acute and is diagnosed within less than two months in most cases. Temporal headache, tenderness and reduced pulsation of the temporal artery combined with significantly elevated ESR are typical features of the disease. A declining incidence from North to South across Europe has been found. The estimated annual incidence in Norway is 20.6-29.1 per 100.000 persons aged 50 years or more, which is among the highest worldwide. The high incidence in the Northern countries and the still incomplete understood ethiopathogenesis should encourage Scandinavian research on GCA.

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