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Giant Cell Aortic Arteritis

Giant Cell Aortitis Horton's


Presentation

  • Here we present a case of GCA combined with ascending aortic dissection and rupture 3 weeks after diagnosis.[jstage.jst.go.jp]
  • Giant cell arteritis, an inflammatory form of vasculitis, may present with a broad spectrum of clinical manifestations and can be complicated by acute ischemic events, the most serious of which is permanent blindness.[books.google.com]
  • The most common presenting symptoms were chest pain (75%) and syncope (18%). Diagnosis was made by computed tomography, transesophageal echocardiogram, and magnetic resonance angiogram in 80%, 13%, and 7% of cases, respectively.[circ.ahajournals.org]
  • GCA is a rare cause of aortic aneurysm in the Japanese population, and a brief review of the literature on this unusual entity is presented following this case report.[link.springer.com]
  • Liu et al. [ 5 ] presented a review of 24 cases of GCA who presented with dissection. The study serves as a historical review of the natural history of the disease.[ejcts.oxfordjournals.org]
Overeating
  • Abstract Giant cell arteritis (GCA) is an autoimmune disease characterized by granulomatous inflammation in the wall of medium-sized and large-sized arteries, and it usually occurs in patients over 50 years of age. 1) Symptoms are nonspecific, and include[jstage.jst.go.jp]
  • Cumulative incidence function plots stratified by GCA status, gender, smoking status and diabetes were used to describe the probability of AA events over time (see figure 2 ) and were tested using the log rank test.[ard.bmj.com]
  • Although 30% of patients with GCA have a vasculitis that involves the aorta and its branches and an increased risk for developing aortic aneurysms, the way these aneurysms change over time and the relationship between aneurysm size and the risk for dissection[mdedge.com]
  • He has engaged in numerous Research Projects, and has authored over 80 papers as well as diverse books and book chapters.[books.google.com]
  • Patient 2 An 81-year-old patient with a history of two myocardial infarctions with an implanted pacemaker was admitted to the hospital for intense pressure pain over a large area in the front part of the chest.[musculoskeletalkey.com]

Workup

  • ., ultrasonography or MRI of the temporal arteries, F18 PET scan) has received increasing attention but it remains uncertain how they should best be integrated into the diagnostic workup.[orpha.net]
  • Since the previous reports have shown frequent aortic involvement even in the early stages of the disease, it is reasonable that all GCA patients should have an initial diagnostic workup focused on the presence of aortitis, given that GCA aortitis remains[jmedicalcasereports.biomedcentral.com]
Elevated Sedimentation Rate
  • The Right Diagnosis Presenting symptoms of GCA aortitis can include pulse deficits, fever, a highly elevated sedimentation rate, aneurysm or aortic dissection. GCA can co-occur with polymyalgia rheumatica.[the-rheumatologist.org]

Treatment

  • Early recognition and adequate treatment of the condition is thus necessary to prevent patients' loss of independence and to maintain their quality of life.[books.google.com]
  • In the setting of GCA an early diagnosis of aortic involvement is mandatory in order to perform a treatment capable of avoiding the chronic and acute complications associated with an elevated mortality [1, 2]. 2010 Elsevier B.V. All rights reserved.[ncbi.nlm.nih.gov]
  • More data are needed to define risk factors for dissection and rupture in patients with GCA related aortic aneurysms and establish screening and treatment guidelines. Footnotes[circ.ahajournals.org]
  • […] for GCA 8 ; it was not therefore possible to separate the effect of treatment and disease in this analysis, and their use was not included as a separate covariate, although their use may theoretically play a role in aneurysm development.[ard.bmj.com]

Prognosis

  • This is important in ensuring a favorable prognosis In most cases, corticosteroid treatment can be stopped after 1-2 years.[dovemed.com]
  • […] shows mural inflammation very well 2,4 mean wall thickness increased in the affected region luminal diameter correspondingly decreased in the affected region reported approximate sensitivity and specificity is 80% and 97%, respectively 2 Treatment and prognosis[radiopaedia.org]
  • Prognosis The disease is chronic and the clinical course is highly variable. Approximately 50% of patients experience subsequent disease flares. Visual loss is the most feared complication.[orpha.net]
  • “Maybe it’s because women exprThere is no evidence right now that if you were to stop the disease entirely that the prognosis of our patients would improve. What Goes Wrong? Dr.[the-rheumatologist.org]
  • Prognosis The visual prognosis is highly dependent on the rapidity with which steroids are started, and the status of the patient’s vision upon presentation.[eyewiki.aao.org]

Etiology

  • Etiology The etiology of giant cell arteritis is unknown. Studies have linked genetic factors, infectious agents and a prior history of cardiovascular disease to the development of giant cell arteritis.[orpha.net]
  • (Etiology) The exact cause of Giant Cell Arteritis is largely unknown However, it is known that the risk of developing GCA increases with an advancing age.[dovemed.com]
  • Etiology The underlying etiology of GCA is is complex and has been widely researched, yet is still not well understood.[eyewiki.aao.org]

Epidemiology

  • Epidemiology Giant Cell Arteritis Cardiovascular Disease Statistics from Altmetric.com Epidemiology Giant Cell Arteritis Cardiovascular Disease Introduction Giant cell arteritis (GCA) is the most common form of vasculitis in the UK, with an incidence[ard.bmj.com]
  • In this review we discuss the pathophysiology of this disease and also the issues of epidemiology and sex differences.[ucdavis.pure.elsevier.com]
  • From the *Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA; and †Division of Rheumatology, Department of Medicine, and Divisions of ‡Biostatistics and §Epidemiology[journals.lww.com]
  • Summary Epidemiology GCA is the most common adulthood vasculitis with an annual incidence of 1/3,000-1/25,000 adults over 50 years old. It is more frequent in populations of northern European background.[orpha.net]
  • In an epidemiological study [ 2 ] from Olmsted County, Minnesota, USA, the local county of the Mayo Clinic, the annual incidence of TA was found to be 17/100 000 person-years.[ejcts.oxfordjournals.org]
Sex distribution
Age distribution

Pathophysiology

  • In this review we discuss the pathophysiology of this disease and also the issues of epidemiology and sex differences.[ucdavis.pure.elsevier.com]
  • J Rheumatol 2015 ; 42 : 1213 – 7 . 9 Giant cell arteritis: a review of classification, pathophysiology, geoepidemiology and treatment . Autoimmun Rev 2012 ; 11 : A544 – 54 . 10 .[ejcts.oxfordjournals.org]
  • The pathophysiology of this protective effect may be related to advanced glycation inducing collagen cross-linking and strengthening of the aortic media. 30 Prior use of antihypertensive medications is also associated with subsequent AA in this study,[ard.bmj.com]
  • Polymyalgia rheumatica can also exist as a distinct entity with no evidence of vascular involvement. 6 This chapter presents the epidemiology, pathophysiology, clinical manifestations, and treatment options for GCA, with particular reference to manifestations[clinicalgate.com]
  • Giant cell arteritis: a review of classification, pathophysiology, geoepidemiology and treatment. Autoimmun Rev. 2012 May;11(6-7):A544-54. Epub 2012 Jan 21. Kesten F, Aschwanden M, Gubser P, Glatz K, Daikeler T, Hess C.[medicine.uiowa.edu]

Prevention

  • Early recognition and adequate treatment of the condition is thus necessary to prevent patients' loss of independence and to maintain their quality of life.[books.google.com]
  • Low-dose aspirin (81 to 100 mg orally once a day) may help prevent ischemic events and should be prescribed for all patients unless contraindicated. 1.[msdmanuals.com]
  • This study will evaluate the effectiveness of abatacept in treating GCA and TAK and preventing disease relapse.[clinicaltrials.gov]
  • If you're diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss. Causes With giant cell arteritis, the lining of arteries becomes inflamed, causing them to swell.[mayoclinic.org]
  • Early treatment is vital to prevent serious complications such as blindness or stroke. GCA is typically treated with high doses of corticosteroids such as prednisone, sometimes in combination with other medications that suppress the immune system.[vasculitisfoundation.org]

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