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.

scholarly journals Classically Presenting GCA with an Unusual Evolution

2021 ◽  
Vol 16 (3) ◽  
pp. 14-18
Author(s):  
Samuel Doiron ◽  
Simon Guertin ◽  
Sébastien Perron ◽  
Charles Leduc
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Mesenteric Ischemia ◽  
Carotid Arteries ◽  
The Elderly ◽  
Personnes Âgées ◽  
Prise En Charge ◽  
Primary Vasculitis

Giant cell arteritis (GCA) is a primary vasculitis of large and medium-sized arteries. It is the most common vasculitis affecting the elderly. GCA involves the cranial branches of the carotid arteries and classically presents with cranial symptoms such as headache or jaw claudication. Aortitis can occur, and cases of mesenteric ischemia have been reported. Diagnosis can be challenging, and subclinical mesenteric ischemia in GCA may be more prevalent than previously recognized. ResumeL’artérite temporale est une vasculite primaire des artères de gros et de moyen calibre. Il s’agit de la vasculite la plus courante chez les personnes âgées. Elle touche les ramifications crâniennes des carotides, et la forme classique se manifeste par des symptômes crâniens comme la céphalée ou la claudication intermittente de la mâchoire. Une aortite peut survenir, et des cas d’ischémie mésentérique ont été rapportés. Le diagnostic peut être difficile à poser, et l’ischémie mésentérique infraclinique dans les cas d’artérite temporale est peut-être plus fréquente que ce que l’on croyait auparavant. Ce cas met en évidence la nature systémique et l’évolution clinique potentiellement imprévisible de l’artérite temporale. Nous décrivons les caractéristiques histopathologiques de l’atteinte mésentérique et résumons l’état actuel de la documentation scientifique sur le sujet en mettant l’accent sur des stratégies de prise en charge.

Ultrasonographic and FDG-PET imaging in active giant cell arteritis of the carotid arteries

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 269-271 ◽  
Author(s):  
Pfadenhauer ◽  
Rüll
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Arterial Wall ◽  
Carotid Arteries ◽  
Temporal Arteritis ◽  
Temporal Artery ◽  
Metabolic Imaging ◽  
Atypical Manifestations

Inflammation of the arterial wall has been demonstrated by 18 Fluoro-Deoxyglucose PET imaging in patients with Takayasu’s and temporal arteritis. We used ultrasonography and FDG-PET for structural and metabolic imaging of the carotid artery to diagnose giant cell arteritis without biopsy. In a 72 years old patient with isolated clinical and paraclinical signs of severe systemic inflammation ultrasonogaphy showed concentric hypoechogenic mural thickening of the carotid arteries and high FDG uptake in the left carotid, both axillary and subclavian arteries and the aorta. Clinical and paraclinical abnormalities showed a typical response to steroid treatment. In conclusion a combined approach using ultrasound and FDG-PET seems to be helpful in the diagnosis of GCA of large arteries particularily in patients with atypical manifestations of the disease and negative or unavailable biopsy of the temporal artery.

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.

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....

An unusual presentation of giant cell arteritis

VASA ◽  
2005 ◽  
Vol 34 (2) ◽  
pp. 128-130 ◽  
Author(s):  
Simon ◽  
Fritz ◽  
Amann-Vesti ◽  
Schenk Romer ◽  
Fischer ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Nasal Septum ◽  
Rare Complication ◽  
Temporal Artery ◽  
Temporal Artery Biopsy ◽  
Elderly Persons ◽  
First Case ◽  
Scalp Necrosis ◽  
Vessel Involvement

A 77-year-old-man with giant cell arteritis who developed bitemporal scalp ulcerations is described. Since 1946 when Cooke et al. reported the first case of scalp necrosis there were approximately 55 cases published. Scalp ulceration is a rare complication of giant cell arteritis and occurs mainly in elderly persons, particularly women. About half of all patients were presented to dermatologists. Most of the patients (70%) had other serious complications of giant cell arteritis: blindness, gangrene of the tongue and nasal septum necrosis. Seventy percent of the cases were confirmed by a temporal artery biopsy. The necrosis were of varying extent and uni- or bilateral. Although, in most cases necrosis has been located bilaterally as in the presented case. Scalp healing was complete nearly in all patients by conservative treatment within a year. Scalp ulceration is a potentially reversible complication of giant cell arteritis which indicates extensive vessel involvement and adequate coricosteroid therapy is required and essential.

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.

Introducing an ANP-led temporal artery biopsy service for patients with suspected giant cell arteritis

2021 ◽  
Vol 30 (9) ◽  
pp. 512-519
Author(s):  
John Cooper
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Nurse Practitioner ◽  
Temporal Arteritis ◽  
Temporal Artery ◽  
Medical Emergency ◽  
Temporal Artery Biopsy ◽  
Sight Loss

Giant cell arteritis (GCA) is an uncommon autoimmune inflammatory vasculopathy that can lead to the destruction and occlusion of various arteries that consequently can cause serious complications such as stroke or sight loss. It is seen as a medical emergency. The most commonly affected vessel in GCA is the temporal artery in the side of the head, hence the condition is sometimes also referred to as ‘temporal arteritis’. This article discusses the introduction of an advanced nurse practitioner-led temporal artery biopsy service.

scholarly journals Temporal Artery Vascular Diseases

2022 ◽  
Vol 11 (1) ◽  
pp. 275
Author(s):  
Hélène Greigert ◽  
André Ramon ◽  
Georges Tarris ◽  
Laurent Martin ◽  
Bernard Bonnotte ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Temporal Arteritis ◽  
Checkpoint Inhibitors ◽  
Vascular Diseases ◽  
Temporal Artery ◽  
Immunoglobulin G4 ◽  
Varicella Zoster ◽  
Related Disease ◽  
Anca Associated Vasculitis

In the presence of temporal arteritis, clinicians often refer to the diagnosis of giant cell arteritis (GCA). However, differential diagnoses should also be evoked because other types of vascular diseases, vasculitis or not, may affect the temporal artery. Among vasculitis, Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is probably the most common, and typically affects the peri-adventitial small vessel of the temporal artery and sometimes mimics giant cell arteritis, however, other symptoms are frequently associated and more specific of ANCA-associated vasculitis prompt a search for ANCA. The Immunoglobulin G4-related disease (IgG4-RD) can cause temporal arteritis as well. Some infections can also affect the temporal artery, primarily an infection caused by the varicella-zoster virus (VZV), which has an arterial tropism that may play a role in triggering giant cell arteritis. Drugs, mainly checkpoint inhibitors that are used to treat cancer, can also trigger giant cell arteritis. Furthermore, the temporal artery can be affected by diseases other than vasculitis such as atherosclerosis, calcyphilaxis, aneurysm, or arteriovenous fistula. In this review, these different diseases affecting the temporal artery are described.

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.

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