Arterial lesions in giant cell arteritis: A longitudinal study
Tanaz A Kermani1, Sehriban Diab2, Antoine G Sreih3
1Division of Rheumatology, University of California Los Angeles, 2020 Santa Monica Boulevard, Suite 540 Santa Monica, CA 90404.
Seminars in Arthritis and Rheumatism
|June 9, 2018
Summary
Giant cell arteritis (GCA) patients often show large-vessel abnormalities on initial imaging. New arterial lesions develop in those with existing abnormalities, even without active disease symptoms, highlighting the need for serial imaging.
Area of Science:
- Rheumatology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting medium and large arteries.
- Large-vessel involvement is a significant manifestation of GCA, impacting diagnosis and management.
- Serial imaging plays a crucial role in monitoring disease progression and treatment response in GCA.
Purpose of the Study:
- To evaluate the occurrence and characteristics of large-vessel (LV) abnormalities in patients with GCA using serial imaging.
- To identify predictors for the development of new arterial lesions in GCA patients.
- To assess the clinical significance of new arterial lesions in the context of GCA activity.
Main Methods:
- Analysis of clinical and imaging data from a prospective, multicenter, longitudinal study and/or randomized clinical trial of GCA patients.
- Inclusion of patients diagnosed via LV imaging.
- Definition of new arterial lesions as those appearing in previously unaffected arteries.
Main Results:
- 187 GCA patients were included; 66% had arterial lesions on initial imaging, most commonly affecting subclavian, axillary, and thoracic aorta.
- In 106 patients with serial imaging, 39% developed new arterial lesions over a mean follow-up of 4.39 years.
- New lesions occurred in patients with baseline abnormalities, often without concurrent clinical signs of active disease.
Conclusions:
- Large-vessel abnormalities are common at diagnosis in GCA patients.
- New arterial lesions can develop in GCA patients with pre-existing abnormalities, irrespective of active disease symptoms.
- Arterial imaging at diagnosis and serial imaging for patients with baseline abnormalities are recommended in GCA management.
Keywords:
Aortic aneurysmComputed tomography angiographyDisease activityGiant cell arteritisLarge-artery stenosisMagnetic resonance angiographyMore Related Videos
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