scholarly journals Calciphylaxis of the temporal artery simulating temporal arteritis

2021 ◽  
pp. 15-18
Author(s):  
Jesica Gallo ◽  
Eduardo Henares ◽  
Sergio Paira

Calciphylaxis is characterized by intense deposition of calcium in small blood vessels, skin, and other organs, described mainly in patients with chronic renal insufficiency, renal transplant of parathyroid dysfunction. To date, there are only seven cases described in literature of calciphylaxis mimicking giant cell arteritis (GCA). In this review, we present the eighth case pathologically documented.

Author(s):  
Jan Tore Gran

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....


2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Safa Idoudi ◽  
Marouene Ben Kahla ◽  
Fares Mselmi ◽  
Badreddine Sriha ◽  
A. Guiga ◽  
...  

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.


2008 ◽  
Vol 18 (2) ◽  
pp. 91-101 ◽  
Author(s):  
H A Bird ◽  
Helen Mac Iver

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.


2021 ◽  
Vol 30 (9) ◽  
pp. 512-519
Author(s):  
John Cooper

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.


2022 ◽  
Vol 11 (1) ◽  
pp. 275
Author(s):  
Hélène Greigert ◽  
André Ramon ◽  
Georges Tarris ◽  
Laurent Martin ◽  
Bernard Bonnotte ◽  
...  

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.


2018 ◽  
Vol 15 (6) ◽  
pp. 51-58
Author(s):  
Adina Cociorvei ◽  
Mădălina Ababei

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.


VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 269-271 ◽  
Author(s):  
Pfadenhauer ◽  
Rüll

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.


2018 ◽  
Vol 24 (8) ◽  
pp. 440-442 ◽  
Author(s):  
Thomas Planté-Bordeneuve ◽  
Liesbet Henckaerts ◽  
Evelyne Lerut ◽  
Eric Verbeken ◽  
Daniël Blockmans

2018 ◽  
Vol 69 (1) ◽  
pp. 152-154
Author(s):  
Vasilica Cristescu ◽  
Aurelia Romila ◽  
Luana Andreea Macovei

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.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 95.3-95
Author(s):  
A. Sachdev ◽  
S. Dubey ◽  
C. Tiivas ◽  
M. George ◽  
P. Mehta

Background:A number of centres are now running fast track pathways for diagnosis and management of Giant cell arteritis with ultrasound as the first port of call for diagnosis1. Temporal artery biopsies (TABs) have become the second line of investigation, and it is unclear how useful TAB is in this setting.Objectives:This study looked at accuracy of Temporal artery biopsy (TAB) in patients with suspected Giant Cell arteritis (GCA) with negative/inconclusive ultrasound (U/S) and how duration of treatment on steroids prior to these investigations and arterial specimen size affected it.Methods:Prospective study of all patients with suspected GCA referred for TAB when U/S was negative or inconclusive, as part of the local fast-track pathway (Coventry). Database included clinical findings, serological work up, U/S and TAB results and treatment. Sensitivity and specificity of U/S and TAB was calculated and compared based on duration of treatment with steroids.Results:One hundred and nine patients were referred for TAB via Coventry fast-track-pathway. The sensitivity of U/S in this cohort of patients was 9.08% and specificity was 93.33%. After 3 days of steroid this was 0% and 100% respectively. For TAB when done within 10 days of starting steroids, this was 65% and 87.5% respectively. After 20 days of steroids this was 0 % and 100%. The sensitivity and specificity was 20% and 85% when arterial specimen size was 11-15mm and 47% and 100% when specimen size was 16 mm or more. Sensitivity and specificity of U/S of 644 suspected GCA patients was 48% and 98%.Conclusion:Our study demonstrates that TAB plays a relevant role in GCA fast-track-pathways, when U/S is negative/inconclusive. TAB was more sensitive than U/S in this cohort of patients, but overall sensitivity of U/S was higher when calculated for all patients suspected with GCA. Both remain useful tests if performed early. TAB specimen size should ideally be 16mm or more and done within 10 days of starting steroids.References:[1]Jonathan Pinnell, Carl Tiivas, Kaushik Chaudhuri, Purnima Mehta, Shirish Dubey, O38 The diagnostic performance of ultrasound Doppler in a fast-track pathway for giant cell arteritis,Rheumatology, Volume 58, Issue Supplement_3, April 2019, kez105.036,https://doi.org/10.1093/rheumatology/kez105.036Disclosure of Interests:None declared


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