Updates in the Diagnosis and Management of Giant Cell Arteritis

AbstractPurpose of ReviewGiant cell arteritis is a systemic large vessel vasculitis that affects the older population and can cause progressive and at times, devastating complications including vision loss. While this has been commonly diagnosed and treated among vasculitides, the treatment options are limited and can have long-term adverse effects. The purpose of our review on GCA is to identify and discuss the pathophysiology and clinical aspects of GCA as they relate to the most recent data. The review will describe any new data on the diagnosis and treatment of this systemic large vessel vasculitis.Recent FindingsThe latest data suggests that the mainstay of treatment of GCA remains glucocorticoids but alternate agents are being identified and used in an attempt to reduce the cumulative exposure to glucocorticoids and reduce treatment-related adverse effects while managing and maintaining remission of this systemic disease.SummaryThere is much more information to collect in terms of identification and standardization of the optimal length of time to treat with glucocorticoids as well as regarding the long-term efficacy of alternate treatments. In addition, investigation continues to identify measureable risk factors to predict outcomes of individual patients with this diagnosis.
Source: Current Neurology and Neuroscience Reports - Category: Neuroscience Source Type: research

Related Links:

CONCLUSION: Ultra-widefield imaging is a very helpful tool in the management of a patient with Eales'disease. PMID: 32463328 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
CONCLUSIONS: TINU occurs in all age groups. Posterior segment manifestations are common. Most patients required systemic steroid therapy, with a significant number requiring long-term systemic immunomodulation. Careful fundus examination is required on all patients with TINU. PMID: 32463299 [PubMed - as supplied by publisher]
Source: Ocular Immunology and Inflammation - Category: Allergy & Immunology Tags: Ocul Immunol Inflamm Source Type: research
We report a case of a patient with well-controlled rheumatoid arthritis, who was treated for GPA based on lung biopsy results with glucocorticoids (GC). Upon re-review of the initial pathology, along with peripheral eosinophilia and history of recent travel, the patient was eventually diagnosed with angiostrongylus-like nematode infection. GCs were subsequently discontinued and instead, the patient was treated with anthelmintics with complete resolution of symptoms. Commonly associated with eosinophilic meningitis or abdominal angiostrongyliasis in humans, clinical pulmonary manifestations of this parasite species are rare...
Source: Rheumatology International - Category: Rheumatology Source Type: research
We describe a rare case of a patient presenting with eosinophilic myositis, who subsequently developed fulminant EGPA. The patient ’s diagnosis was supported by an initial clinical presentation of weakness and elevated CK, followed by fleeting pulmonary infiltrates and mononeuritis multiplex, peripheral eosinophilia, and strongly positive myeloperoxidase anti-cytoplasmic antibody (MPO-ANCA). Muscle biopsy revealed eosinophili c myositis. The patient responded well to high-dose glucocorticoids and cyclophosphamide with improved symptoms and biochemical markers. Based on our literature review, there are only seven simi...
Source: Rheumatology International - Category: Rheumatology Source Type: research
The analysis of the main features of randomized controlled trials (RCTs) on ANCA-associated vasculitis (AAV) can inform future study design.
Source: Orphanet Journal of Rare Diseases - Category: Internal Medicine Authors: Tags: Research Source Type: research
Conclusion: To our knowledge, this is the first report of successful use of anti-TNF-α therapy for a patient with granulomatous hypophysitis, in this case associated with a previous diagnosis of CD. Although glucocorticoids are used frequently as first-line therapy for primary hypophysitis, granulomatous hypophysitis can be corticosteroid resistant and other immunosuppressive approaches may need to be considered within the context of the patient.
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
We assessed the rate of and predictors for all-cause mortality in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) receiving plasma exchange (PLEX) and evaluated the surviva...
Source: BMC Pulmonary Medicine - Category: Respiratory Medicine Authors: Tags: Research article Source Type: research
A 43-year-old male pet shop owner on leflunomide for seronegative rheumatoid arthritis presented locally with strange behavior and aphasia, preceded by flu-like symptoms and high fevers. Initial workup revealed cerebrospinal fluid lymphocytic pleocytosis (22 cells, 74% lymphocytes), for which he was started on empiric antimicrobial therapy. A brain MRI revealed extensive, bilateral ischemic strokes (Figure 1). A transesophageal echocardiogram (TEE) was negative. He was then transferred to our institution for further evaluation.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
We present a case of a 71-year-old male patient with systemic vasculitis, showing recurrent symptoms despite pharmacological treatment. Clinical and partial immunological improvement were achieved after the removal of thoracic schwannoma.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Communication to Editors Source Type: research
A nagyérvasculitisek képalkotó vizsgálatának lehetőségei és azok jelentősége. Orv Hetil. 2020 Jun;161(23):939-950 Authors: Kolossváry E, Balázs G, Dósa E, Moravszki M, Járai Z, Farkas K Abstract According to the nomenclature of the Chapel Hill Consensus Conference, giant-cell arteritis and Takayasu's arteritis belong to the group of large-vessel vasculitis. Recognition of these diseases is primarily based on the clinical assessment and the use of various vascular imaging modalities. With regard to the latter one, sig...
Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
More News: Brain | Eyes | Neurology | Neuroscience | Vasculitis