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

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Giant cell arteritis: is the clinical spectrum of the disease changing?

Miguel Á González-Gay1,2,3, Miguel Ortego-Jurado4, Liliana Ercole5

  • 1Division of Rheumatology and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla, 39011, Santander, Spain. miguelaggay@hotmail.com.

BMC Geriatrics
|July 31, 2019
PubMed

Insights

Giant cell arteritis (GCA) is an inflammatory vasculitis affecting older adults. Recognizing its diverse presentations and utilizing advanced imaging aids in early diagnosis to prevent severe complications.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is a large and medium-sized artery vasculitis predominantly affecting individuals over 50.
  • Clinical presentation can vary, including typical cranial symptoms or nonspecific signs with large-vessel involvement.
  • Early diagnosis and treatment are crucial to prevent irreversible damage.

Purpose of the Study:

  • To highlight the heterogeneity of Giant Cell Arteritis presentations.
  • To emphasize the importance of recognizing GCA beyond typical cranial symptoms.
  • To discuss the role of diagnostic tools in identifying GCA, especially with extracranial involvement.

Main Methods:

  • Review of current knowledge on GCA presentation and diagnosis.
  • Discussion of diagnostic modalities including temporal artery biopsy, ultrasonography, FDG-PET/TAC, MRI, and CT.
  • Emphasis on clinical awareness and judicious test selection.

Main Results:

  • GCA presents more heterogeneously than previously recognized.
  • Overlap with polymyalgia rheumatica can lead to underdiagnosis.
  • Advanced imaging techniques are valuable for detecting extracranial large-vessel GCA.

Conclusions:

  • Increased awareness of diverse clinical manifestations is essential for timely GCA detection.
  • Judicious use of diagnostic tests, including newer imaging, can improve diagnostic accuracy.
  • Prompt diagnosis and management of GCA are critical to avoid severe complications.
Abstract

Keywords:
FDG-PET/CTGiant-cell arteritisPolymyalgia rheumatica

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