CZY CHORYCH NA OLBRZYMIOKOMÓRKOWE ZAPALENIE TĘTNIC BADAĆ W KIERUNKU ROZWOJU TĘTNIAKÓW AORTY?

Aortitis is one of the manifestations of giant cell arteritis (GCA) and is included in its definition. There is a significantly increased risk of aortic aneurysm formation in GCA patients. In some GCA patients aortic aneurysm dissection is diagnosed only in autopsy. Monitoring of these patients, especially in long lasting disease, requires a doctor’s awareness of the possibility of aneurysm formation and aortic aneurysm dissection. Based on the available reports it cannot be confirmed whether intensification of aortitis treatment in GCA prevents the development of aneurysms. This article presents an overview of the available literature and our own experience on a rational diagnosis of inflammation and aneurysms of the aorta in GCA, as well as the prospects for its prevention.

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Large-vessel involvement in giant cell arteritis: a population-based cohort study of the incidence-trends and prognosis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-202408 ◽

2012 ◽

Vol 72 (12) ◽

pp. 1989-1994 ◽

Cited By ~ 148

Author(s):

Tanaz A Kermani ◽

Kenneth J Warrington ◽

Cynthia S Crowson ◽

Steven R Ytterberg ◽

Gene G Hunder ◽

...

Keyword(s):

Aortic Aneurysm ◽

General Population ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Population Based ◽

Artery Stenosis ◽

Large Vessel ◽

Large Artery ◽

Incidence Trends ◽

Aneurysm Dissection

ObjectivesTo evaluate incidence-trends and timing of large-vessel (LV) manifestations in patients with giant cell arteritis (GCA), and to examine the influence of LV manifestations on survival.MethodsA population-based incident cohort of patients diagnosed with GCA between 1950 and 2004 was used. LV involvement was defined as large-artery stenosis or aortic aneurysm/dissection that developed in the 1 year before GCA diagnosis or at any time thereafter. Patients were followed up until death or 31 December 2009.ResultsThe study included 204 patients, 80% women, mean age at diagnosis of GCA 76.0 years (±8.2 years). Median length of follow-up was 8.8 years. The cumulative incidence of any LV manifestation at 10 years was 24.9% for patients diagnosed with GCA between 1980 and 2004 compared with 8.3% for patients diagnosed with GCA between 1950 and 1979. The incidence of any LV event was high within the first year of GCA diagnosis. The incidence of aortic aneurysm/dissection increased 5 years after GCA diagnosis. Compared with the general population, survival was decreased in patients with an aortic aneurysm/dissection (standardized mortality ratio (SMR) 2.63; 95% CI 1.78 to 3.73) but not in patients with large-artery stenosis (SMR 1.44; 95% CI 0.87 to 2.25). Patients with GCA and aortic manifestations had a higher than expected number of deaths from cardiovascular and pulmonary causes than the general population. Among patients with GCA, aortic manifestations were associated with increased mortality (HR=3.4; 95% CI 2.2 to 5.4).ConclusionsVigilance and screening for aortic aneurysms should be considered in all patients 5 years after the incidence of GCA. Aortic aneurysm/dissection is associated with increased mortality in GCA.

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Aortic aneurysm and dissection are not associated with an increased risk for giant cell arteritis/ polymyalgia rheumatica

Postgraduate Medical Journal ◽

10.1136/pmj.76.897.409 ◽

2000 ◽

Vol 76 (897) ◽

pp. 409-411 ◽

Cited By ~ 1

Author(s):

M. Ehrenfeld

Keyword(s):

Aortic Aneurysm ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Polymyalgia Rheumatica ◽

Increased Risk ◽

Aortic Aneurysm And Dissection

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Abdominal aortic aneurysm in giant cell arteritis

Annals of Surgical Treatment and Research ◽

10.4174/astr.2015.89.4.224 ◽

2015 ◽

Vol 89 (4) ◽

pp. 224 ◽

Cited By ~ 4

Author(s):

Hyunwook Kwon ◽

Youngjin Han ◽

Da Hye Son ◽

Yong-Pil Cho ◽

Tae-Won Kwon

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Abdominal Aortic

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Successful treatment of dissecting aortic aneurysm due to giant cell arteritis.

Annals of the Rheumatic Diseases ◽

10.1136/ard.40.5.507 ◽

1981 ◽

Vol 40 (5) ◽

pp. 507-508 ◽

Cited By ~ 17

Author(s):

R S Salisbury ◽

B L Hazleman

Keyword(s):

Aortic Aneurysm ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Successful Treatment ◽

Dissecting Aortic Aneurysm

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Thoracic aortic aneurysm and rupture in giant cell arteritis. a descriptive study of 41 cases

Arthritis & Rheumatism ◽

10.1002/art.1780371020 ◽

1994 ◽

Vol 37 (10) ◽

pp. 1539-1547 ◽

Cited By ~ 163

Author(s):

Jonathan M. Evans ◽

Carolyn A. Bowles ◽

Johannes Bjornsson ◽

Charles J. Mullany ◽

Gene G. Hunder

Keyword(s):

Aortic Aneurysm ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Thoracic Aortic Aneurysm ◽

Descriptive Study

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Giant Dissecting Aortic Aneurysm in an Asymptomatic Young Male

Case Reports in Vascular Medicine ◽

10.1155/2015/958464 ◽

2015 ◽

Vol 2015 ◽

pp. 1-2 ◽

Cited By ~ 3

Author(s):

Priyank Shah ◽

Nishant Gupta ◽

Irvin Goldfarb ◽

Fayez Shamoon

Keyword(s):

Aortic Aneurysm ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Hereditary Hemorrhagic Telangiectasia ◽

Surgical Intervention ◽

Young Male ◽

Physical Exam ◽

Ascending Aortic Aneurysm ◽

Rare Finding ◽

Dissecting Aortic Aneurysm

Giant aortic aneurysm is defined as aneurysm in the aorta greater than 10 cm in diameter. It is a rare finding since most patients will present with complications of dissection or rupture before the size of aneurysm reaches that magnitude. Etiological factors include atherosclerosis, Marfan’s syndrome, giant cell arteritis, tuberculosis, syphilis, HIV-associated vasculitis, hereditary hemorrhagic telangiectasia, and medial agenesis. Once diagnosed, prompt surgical intervention is the treatment of choice. Although asymptomatic unruptured giant aortic aneurysm has been reported in the literature, there has not been any case of asymptomatic giant dissecting aortic aneurysm reported in the literature thus far. We report a case of giant dissecting ascending aortic aneurysm in an asymptomatic young male who was referred to our institution for abnormal findings on physical exam.

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Malignancies in Giant Cell Arteritis: A Population-based Cohort Study

The Journal of Rheumatology ◽

10.3899/jrheum.190236 ◽

2019 ◽

Vol 47 (3) ◽

pp. 400-406 ◽

Cited By ~ 2

Author(s):

Pavlos Stamatis ◽

Carl Turesson ◽

Minna Willim ◽

Jan-Åke Nilsson ◽

Martin Englund ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Population Based ◽

Upper Gastrointestinal Tract ◽

Tract Cancer ◽

Gastrointestinal Tract Cancer ◽

Background Population ◽

Increased Risk ◽

Upper Gastrointestinal

ObjectiveTo investigate the risk of cancer in patients with biopsy-proven giant cell arteritis (GCA) from a defined population in southern Sweden.Methods.The study cohort consisted of 830 patients (mean age at GCA diagnosis was 75.3 yrs, 74% women) diagnosed with biopsy-proven GCA between 1997 and 2010. Temporal artery biopsy results were retrieved from a regional database and reviewed to ascertain GCA diagnosis. The cohort was linked to the Swedish Cancer Registry. The patients were followed from GCA diagnosis until death or December 31, 2013. Incident malignancies registered after GCA diagnosis were studied. Based on data on the first malignancy in each organ system, age- and sex-standardized incidence ratios (SIR) with 95% CI were calculated compared to the background population.Results.One hundred seven patients (13%) were diagnosed with a total of 118 new malignancies after the onset of GCA. The overall risk for cancer after the GCA diagnosis was not increased (SIR 0.98, 95% CI 0.81–1.17). However, there was an increased risk for myeloid leukemia (2.31, 95% CI 1.06–4.39) and a reduced risk for breast cancer (0.33, 95% CI 0.12–0.72) and upper gastrointestinal tract cancer (0.16, 95% 0.004–0.91). Rates of other site-specific cancers were not different from expected.Conclusion.In this Swedish population-based cohort of GCA, the overall risk for cancer was not increased compared to the background population. However, there was an increased risk for leukemia and a decreased risk for breast and upper gastrointestinal tract cancer.

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