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.

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 Biopsy findings in giant cell arteritis: relationship to baseline factors and corticosteroid treatment

2013 ◽  
Vol 42 (4) ◽  
pp. 331-332 ◽  
Author(s):  
K Jakobsson ◽  
L Jacobsson ◽  
K Warrington ◽  
EL Matteson ◽  
C Turesson
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Corticosteroid Treatment ◽  
Baseline Factors

Osteoporosis after long-term corticosteroid treatment of giant cell arteritis

1990 ◽  
Vol 227 (6) ◽  
pp. 391-395 ◽  
Author(s):  
R. ANDERSSON ◽  
Å. RUNDGREN ◽  
K. ROSENGREN ◽  
B.-Å. BENGTSSON ◽  
B.-E. MALMVALL ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Corticosteroid Treatment

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.

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.

Arteritic Anterior Ischemic Optic Neuropathy

2011 ◽  
pp. 11-15
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak ◽  
Robert B. Daroff
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Optic Neuropathy ◽  
Corticosteroid Treatment ◽  
Anterior Ischemic Optic Neuropathy ◽  
Medical Emergency ◽  
Ischemic Optic Neuropathy ◽  
Fellow Eye ◽  
Timely Fashion ◽  
Eye Involvement

Arteritic anterior ischemic optic neuropathy occurs in the setting of giant cell arteritis and is a medical emergency, because there is a high risk of fellow eye involvement if corticosteroid treatment is not initiated in a timely fashion. In this chapter, we review the clinical features of arteritic anterior ischemic optic neuropathy. We also discuss the evaluation and treatment of patients with suspected giant cell arteritis.

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