New developments in giant cell arteritis.

Abstract:

:Giant cell arteritis (GCA) is a medium-to-large vessel vasculitis with potentially sight- and life- threatening complications. Our understanding of the pathogenesis, diagnosis, and treatment of GCA has advanced rapidly in recent times. The validity of using the American College of Rheumatology guidelines for diagnosis of GCA in a clinical setting has been robustly challenged. Erythrocyte sedimentation rate, an important marker of inflammation, is lowered by the use of statins and nonsteroidal anti-inflammatory drugs. Conversely, it may be falsely elevated with a low hematocrit. Despite the emergence of new diagnostic modalities, temporal artery biopsy remains the gold standard. Evidence suggests that shorter biopsy lengths and biopsies done weeks to months after initiation of steroid therapy are still useful. New imaging techniques such as positron emission tomography have shown that vascular inflammation in GCA is more widespread than originally thought. GCA, Takayasu arteritis, and polymyalgia rheumatica are no longer thought to exist as distinct entities and are more likely parts of a spectrum of disease. A range of immunosuppressive drugs have been used in conjunction with corticosteroids to treat GCA. In particular, interleukin-6 inhibitors are showing promise as a therapy.

journal_name

Surv Ophthalmol

journal_title

Survey of ophthalmology

authors

Frohman L,Wong AB,Matheos K,Leon-Alvarado LG,Danesh-Meyer HV

doi

10.1016/j.survophthal.2016.01.001

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

400-21

issue

4

eissn

0039-6257

issn

1879-3304

pii

S0039-6257(15)30069-2

journal_volume

61

pub_type

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