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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis

Published on: February 8, 2019

Clinical features of polymyalgia rheumatica and giant cell arteritis

Carlo Salvarani1, Nicolò Pipitone, Annibale Versari

  • 1Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN, Istituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42123 Reggio Emilia, Italy. salvarani.carlo@ asmn.re.it

Nature Reviews. Rheumatology
|July 25, 2012
PubMed

Insights

Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are inflammatory conditions affecting older adults, often women. Diagnosis relies on clinical signs and inflammatory markers, with glucocorticoids as the primary treatment.

Area of Science:

  • Rheumatology
  • Immunology
  • Internal Medicine

Background:

  • Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are distinct yet frequently co-occurring inflammatory diseases.
  • These conditions primarily affect Caucasians over 50, with women disproportionately impacted.
  • PMR presents with shoulder, neck, and pelvic girdle pain/stiffness; GCA involves large and medium arteries, causing headache, jaw claudication, and visual disturbances.

Purpose of the Study:

  • To provide a comprehensive overview of Polymyalgia Rheumatica and Giant Cell Arteritis.
  • To highlight the clinical presentation, diagnostic approaches, and management strategies for these related inflammatory conditions.

Main Methods:

  • Review of clinical features, diagnostic criteria, and treatment modalities for PMR and GCA.
  • Emphasis on the diagnostic role of clinical presentation, inflammatory markers, temporal artery biopsy, and imaging studies.
  • Discussion of the established and emerging therapeutic options.

Main Results:

  • PMR and GCA share common demographic and pathophysiological links.
  • Diagnosis is primarily clinical, supported by elevated inflammatory markers, with specific tests for GCA confirmation.
  • Glucocorticoids are the mainstay of treatment, though GCA often requires higher doses. Immunosuppressants have a role, while biologics are under investigation.

Conclusions:

  • PMR and GCA are significant inflammatory rheumatologic conditions requiring prompt diagnosis and management.
  • Effective treatment, predominantly with glucocorticoids, leads to remission in most cases, but chronic management is sometimes necessary.
  • Further research is needed to clarify the role of biologic agents in managing these diseases.

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