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Recognition of giant cell arteritis in patients with polymyalgia rheumatica who have a stroke: a cautionary tale
Abstract An 82‐year‐old woman with polymyalgia rheumatica (PMR) on prednisone 7 mg daily was admitted to an acute stroke unit with a right homonymous hemianopia, a left posterior cerebral artery occlusion and occipital lobe infarct. She had raised inflammatory markers, did not have a temporal artery biopsy, and was discharged on the same dose of prednisone. After 21 months, off prednisone, her ophthalmologist, concerned about giant cell arteritis (GCA), restarted prednisone 40 mg daily, with rapid, profound visual improvement. After 3 days her general practitioner, noting normal baseline inflammatory markers, stopp...
Source: Internal Medicine Journal - October 9, 2017 Category: Internal Medicine Authors: Donald H. Gutteridge, Frank L. Mastaglia Tags: Brief Communication Source Type: research

Ischemic stroke caused by giant cell arteritis associated with pulmonary adenocarcinoma
We describe a 77-year-old man with a sudden onset of dizziness, vomiting, and gait disturbances. Following imaging studies, a diagnosis of bulbar ischemic stroke with left vertebral artery stenosis was made. Based on a history of polymyalgia rheumatica, on laboratory tests, and brain digital subtraction angiography, a diagnosis of GCA was advanced and the patient underwent high-dose steroidal therapy. After a total body 18-FGD PET imaging, a pulmonary adenocarcinoma was found.Vertebral artery involvement is a rare but important occurrence in GCA as it carries a high mortality rate, and may require a vigorous therapeutic ap...
Source: Journal of Clinical Neuroscience - November 5, 2019 Category: Neuroscience Source Type: research

Inflammatory Muscle Disorder May Raise Risk for Heart Attack, Stroke
Patients with polymyalgia rheumatica may be more likely to develop vascular disease, study shows Source: HealthDay Related MedlinePlus Pages: Heart Attack, Polymyalgia Rheumatica, Stroke
Source: MedlinePlus Health News - July 28, 2014 Category: Consumer Health News Source Type: news

Getting the Right Care for Painful Autoimmune Conditions
A corticosteroid can quickly relieve symptoms of both polymyalgia rheumatica and temporal arteritis. But a delay could cause vision loss, a stroke or even death.
Source: NYT Health - August 19, 2019 Category: Consumer Health News Authors: Jane E. Brody Tags: Stroke Steroids Autoimmune Diseases Immune System Source Type: news

Neurological Involvement in Primary Systemic Vasculitis
Conclusion Neurological involvement is a common complication of PSV (Table 1), and neurologists play an important role in the identification and diagnosis of PSV patients with otherwise unexplained neurological symptoms as their chief complaint. This article summarizes the neurological manifestations of PSV and hopes to improve neuroscientists' understanding of this broad range of diseases. TABLE 1 Table 1. Common CNS and PNS involvements of primary systemic vasculitis. Author Contributions SZ conceived the article and wrote the manuscript. DY and GT reviewed and edited the manuscript. All authors ...
Source: Frontiers in Neurology - April 25, 2019 Category: Neurology Source Type: research

Prevalence and significance of ischemic cerebrovascular events in giant cell arteritis.
CONCLUSIONS: Stroke and TIA are common presentation patterns associated with GCA and should be suspected in all CVE-related cases with high acute-phase reactants commonly present in the elderly. This ischemic subgroup exhibited a higher mortality rate. PMID: 32826078 [PubMed - as supplied by publisher]
Source: Medicina Clinica - August 23, 2020 Category: General Medicine Tags: Med Clin (Barc) Source Type: research

Risk factors for severe cranial ischaemic complications in giant cell arteritis
ConclusionIncreasing age, jaw claudication and smoking predicted sCIC, while higher CRP decreased the risk of sCIC in our GCA cohort.
Source: Rheumatology - March 3, 2020 Category: Rheumatology Source Type: research

Polymyalgia Rheumatica Increases Heart Attack, Stroke Risk Polymyalgia Rheumatica Increases Heart Attack, Stroke Risk
Polymyalgia rheumatica has been associated with more than double the risk for cerebrovascular, cardiovascular, and peripheral vascular events. Medscape Medical News
Source: Medscape Medical News Headlines - July 28, 2014 Category: Consumer Health News Tags: Rheumatology News Source Type: news

Subclinical Atherosclerosis in Primary Sj ögren's Syndrome: Does Inflammation Matter?
Conclusions The markers of endothelial activation and damage and of chronic inflammation investigated until now failed to result predictors of subclinical atherosclerosis or to be associated with increased risk of CV events in SS patients. This may suggest that other mechanisms are implicated with increased prevalence of subclinical atherosclerosis in SS or that these biomarkers exert a different mechanism in the pathogenesis of endothelial damage and in the induction of atherosclerosis. Surely, the relationship between the disease itself and inflammatory and immune dysfunction factors is quite complex and still to be cla...
Source: Frontiers in Immunology - April 16, 2019 Category: Allergy & Immunology Source Type: research

The diagnosis and classification of giant cell arteritis.
Abstract Giant-cell arteritis (GCA) involves the major branches of the aorta with predilection for the extracranial branches of the carotid artery. It occurs in individuals older than 50 years and the incidence increases with age. The signs and symptoms of giant cell arteritis can be classified into four subsets: cranial arteritis, extracranial arteritis, systemic symptoms and polymyalgia rheumatica. Patients may develop any combination of these manifestations, associated with laboratory evidence of an acute-phase reaction. The only test that confirms GCA diagnosis is a temporal artery biopsy, showing vasculitis w...
Source: Journal of Autoimmunity - January 21, 2014 Category: Allergy & Immunology Authors: Nesher G Tags: J Autoimmun Source Type: research

Bilateral scalp necrosis as a rare but devastating complication of giant cell arteritis
We report a case of a man who presented with a 4-week history of bilateral scalp necrosis associated with headache, jaw claudication, temporal artery tenderness, and raised inflammatory markers. He did not have any visual loss. A diagnosis of GCA was made and he was started on high-dose steroids immediately. The scalp lesions did improve and his symptoms resolved without any visual loss but, sadly he died due to severe sepsis. This case report is important as it describes a rare but severe complication of a common large vessel vasculitis seen by both primary care physicians and rheumatologists. Prompt recognition and early...
Source: Clinical Rheumatology - January 1, 2015 Category: Rheumatology Source Type: research

P211  Aortitis: clinical experience within a tertiary centre
Conclusion Systemic inflammatory response syndrome was the commonest presenting feature. Those without GCA-like symptoms received a delayed diagnosis, which increases the risk of preventable vascular events. CT-PET remained the main diagnostic tool. Prednisolone treatment was prolonged with burdensome side- effects. Methotrexate remained the DMARD of choice, but leflunomide also showed good results. Vascular complications are common and need attention.Disclosure R.S. Andev: None.N. Ahmad: None.R. Luqmani: None.S. Dubey: None.
Source: Rheumatology - April 26, 2021 Category: Rheumatology Source Type: research