Recent advances in the diagnosis and management of giant cell arteritis

Purpose of review Giant cell arteritis (GCA) has classically been diagnosed by temporal artery biopsy and treated with high-dose, long-term glucocorticoid therapy. Noninvasive imaging increasingly is employed for diagnostic purposes, but further studies are needed to determine the role of imaging in monitoring longitudinal disease activity. Glucocorticoid-sparing therapy mitigates the numerous adverse effects of glucocorticoids. This review addresses new developments in these areas. Recent findings For diagnosis, when performed at a center with expertise in its use, temporal artery ultrasound has an estimated sensitivity and specificity of 78 and 79%, respectively. State-of-the-art time-of-flight positron emission tomography/computed tomography (PET/CT) has an estimated sensitivity and specificity of 71 and 91%, respectively. The sensitivities of both imaging modalities decrease following glucocorticoid administration. Tocilizumab is an effective glucocorticoid-sparing therapy, demonstrating sustained glucocorticoid-free remission in 56% of patients receiving weekly tocilizumab compared with 18% of patients receiving a 52-week prednisone taper. The traditional acute phase reactants are of no value in patients treated with interleukin-6 receptor (IL6-R) blockade, and thus, the development of new biomarkers is an important priority in the field. Summary Noninvasive imaging techniques are increasingly used in the absence of temporal artery biopsy to confirm diagnostic su...
Source: Current Opinion in Rheumatology - Category: Rheumatology Tags: CLINICAL THERAPEUTICS AND HEMATOLOGIC COMPLICATIONS: Edited by W. Joseph McCune Source Type: research

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AbstractFelty ’s syndrome (FS) is a deforming disease, characterized by the triad of rheumatoid arthritis (RA), neutropenia, and splenomegaly. Currently, FS patients are treated mainly with immunosuppressants, such as methotrexate and glucocorticoids, which however are not suitable to some patients and may caus e severe side effects. Here we report a clinical FS case that was treated with Tocilizumab (TCZ) successfully. The patient had symmetrical swelling and pain of multiple joints, deformity of elbow joints with obvious morning stiffness. Joint color Doppler ultrasound showed synovial hyperplasia and bo ne erosion...
Source: Rheumatology International - Category: Rheumatology Source Type: research
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Source: International Journal of Endocrinology - Category: Endocrinology Tags: Int J Endocrinol Source Type: research
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Source: Orvosi Hetilap - Category: General Medicine Authors: Tags: Orv Hetil Source Type: research
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Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research
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Source: Journal of Pediatric Urology - Category: Urology & Nephrology Authors: Source Type: research
Nines, a teleradiology company based in Palo Alto, CA, recently received FDA clearance for their NinesAI medical device, which supports the automated radiological review of CT Head images for the possible presence of two time-critical, life-threateni...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Radiology Telemedicine Source Type: blogs
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Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
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Source: Digestive and Liver Disease - Category: Gastroenterology Authors: Tags: Image of the Month Source Type: research
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Source: Medical Ultrasonography - Category: Radiology Tags: Med Ultrason Source Type: research
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Source: European Radiology - Category: Radiology Source Type: research
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