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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

[Giant-cell arteritis: update: diagnosis and therapy]

M Schirmer1, C Dejaco, W A Schmidt

  • 1Labor für Molekulare Biologie und Rheumatologie, Allgemeine Ambulanz und Rheumaambulanz, Univ.-Klinik für Innere Medizin I, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich. michael.schirmer@i-med.ac.at

Zeitschrift Fur Rheumatologie
|November 10, 2012
PubMed

Insights

Giant-cell arteritis (GCA), a common vasculitis in older adults, often affects extracranial arteries. Early diagnosis and treatment with glucocorticoids, methotrexate, and aspirin are crucial for preventing severe complications like vision loss.

Area of Science:

  • Rheumatology
  • Immunology
  • Vascular Medicine

Context:

  • Giant-cell arteritis (GCA) is the most prevalent vasculitis affecting individuals over 50.
  • Vision loss is a common severe complication, though extracranial artery involvement, including the aorta, is more frequent than previously recognized.

Purpose:

  • To review the current understanding of GCA, encompassing its epidemiology, pathophysiology, diagnostic challenges, imaging modalities, and therapeutic strategies.
  • To highlight the diagnostic difficulties due to the lack of specific laboratory tests and the importance of imaging in assessing vascular involvement.

Summary:

  • The pathophysiology involves dendritic and T-cells, suggesting an antibody presence, but a definitive link to infections remains unproven.
  • While blood inflammatory markers are often elevated, specific diagnostic tests for GCA are lacking.
  • Diagnostic imaging, including ultrasonography, MRI, and FDG-PET, aids in localizing and determining the extent of vascular inflammation.

Impact:

  • Glucocorticoids remain the standard GCA treatment, with methotrexate potentially reducing cumulative dosage.
  • Acetylsalicylic acid is recommended for prophylaxis of cardiovascular and cerebrovascular events and for managing associated osteoporosis.

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