Large vessel involvement in biopsy-proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography
| Autor: | Itziar Tavera-Bahillo, Maria C. Cid, Marcelo Sánchez, Josep M. Grau, Georgina Espígol-Frigolé, Ana García-Martínez, Montserrat Butjosa, Pedro Arguis, Sergio Prieto-González, José Hernández-Rodríguez |
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| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Immunology Giant Cell Arteritis Aortography General Biochemistry Genetics and Molecular Biology Rheumatology Large vessel vasculitis medicine.artery Biopsy medicine Immunology and Allergy Thoracic aorta Humans Prospective Studies Prospective cohort study Aorta Aged Aged 80 and over medicine.diagnostic_test business.industry Middle Aged medicine.disease Giant cell arteritis Angiography cardiovascular system Female Radiology Splanchnic business Tomography X-Ray Computed Dilatation Pathologic |
| Zdroj: | Annals of the rheumatic diseases. 71(7) |
| ISSN: | 1468-2060 |
| Popis: | Necroscopic and surgical studies have suggested that giant cell arteritis (GCA) may target the aorta and its main branches. Imaging techniques are able to detect large vessel vasculitis (LVV) non-invasively in patients, but the prevalence of LVV in GCA has not been clearly established.To assess prospectively the prevalence, characteristics and topography of LVV in patients with newly diagnosed GCA and to determine the associated clinical and laboratory features.CT angiography (CTA) was performed in 40 consecutive patients with newly diagnosed biopsy-proven GCA. Patients were treatment-naïve or had been treated with corticosteroids for3 days. Vessel wall thickness and vessel diameter (dilation or stenoses) at four aortic segments (ascending aorta, aortic arch, descending thoracic and abdominal aorta) and at the main aortic branches were evaluated.LVV was detected in 27 patients (67.5%). The vessels involved were as follows: aorta (26 patients, 65%), brachiocephalic trunk (19 patients, 47.5%), carotid arteries (14 patients, 35%), subclavian arteries (17 patients, 42.5%), axillary arteries (7 patients, 17.5%), splanchnic arteries (9 patients, 22.5%), renal arteries (3 patients, 7.5%), iliac arteries (6 patients, 15%) and femoral arteries (11 patients, 30%). Dilation of the thoracic aorta was already present in 6 patients (15%). Cranial ischaemic events were significantly less frequent in patients with LVV (p=0.029). Treatment-naïve patients had a higher frequency of LVV (77% vs 29%, p=0.005).CTA-defined LVV occurs in two-thirds of patients with GCA at the time of diagnosis and aortic dilation is already present in 15%. Previous corticosteroid treatment may decrease CTA-detected LVV. |
| Databáze: | OpenAIRE |
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