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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Vessel involvement in giant cell arteritis: an imaging approach
Pieter W Holm1, Maria Sandovici, Riemer H J A Slart
1Department of Internal Medicine, University of Groningen/University Medical center Groningen, Groningen, The Netherlands - e.brouwer@umcg.nl.
Insights
Giant cell arteritis (GCA) diagnosis is evolving. While temporal artery biopsy was the gold standard, new imaging techniques now reveal widespread GCA involvement and aid treatment assessment.
Area of Science:
- Rheumatology and Immunology
- Vascular Medicine
Background:
- Vasculitis encompasses inflammatory conditions affecting blood vessels, categorized by vessel size.
- Large vessel vasculitis (LVV) includes Takayasu arteritis, giant cell arteritis (GCA), isolated aortitis, and chronic periaortitis.
- GCA is characterized by giant cells in arterial walls, historically diagnosed via temporal artery biopsy.
Purpose of the Study:
- To review the diagnostic evolution of GCA, focusing on the impact of advanced imaging.
- To highlight the role of imaging in assessing extracranial involvement and vascular damage in GCA.
- To discuss the utility of imaging in guiding GCA treatment evaluation.
Main Methods:
- Review of literature on GCA diagnosis and management.
- Analysis of the impact of new imaging modalities on GCA diagnosis.
- Comparison of traditional biopsy methods with modern imaging techniques.
Main Results:
- Recent imaging techniques demonstrate significant extracranial GCA involvement, challenging the sole reliance on temporal artery biopsy.
- Imaging is crucial for identifying the extent of vascular damage in GCA patients.
- Imaging plays a vital role in monitoring treatment response and effectiveness in GCA.
Conclusions:
- The diagnostic paradigm for GCA is shifting due to advancements in imaging technology.
- Imaging offers a comprehensive assessment of GCA, including extracranial manifestations and vascular damage.
- Imaging is integral to modern GCA management, aiding diagnosis and treatment evaluation.
Abstract:
Vasculitis is classified based on the size of the involved vessels. The two major forms are small vessel vasculitis and large vessel vasculitis (LVV). Main forms of LVV are Takayasu arteritis, giant cell arteritis (GCA), isolated aortitis and chronic periaortitis. This manuscript will focus on GCA, named after the presence of giant cells in the artery vessel wall. A positive biopsy of the temporal artery is the gold standard for making a diagnosis of GCA. In the past 10 years the introduction of new imaging techniques in GCA patients has revealed a variable prevalence of extra cranial involvement, challenging the temporal artery biopsy as gold standard. Also, imaging has become important not only for diagnosing GCA but also for assessment of vascular damage in GCA and for the evaluation of treatment.
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