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Published on: February 8, 2019
Giant cell arteritis versus Takayasu's Arteritis: Two sides of the same coin?
Peter W Mortensen1, Subahari Raviskanthan1, Patricia Chévez-Barrios1,2,3,4,5
1Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.
Insights
Takayasu's arteritis (TkA) and giant cell arteritis (GCA) are large vessel vasculitides with shared features. Research suggests they might be different forms of the same disease, though this is debated.
Area of Science:
- Rheumatology
- Immunology
- Vascular Medicine
Background:
- Takayasu's arteritis (TkA) and giant cell arteritis (GCA) are medium to large vessel vasculitides.
- These conditions differ in demographics, vascular involvement, and treatment.
- Shared histopathology, genetics, and clinical overlap suggest a potential link.
Purpose of the Study:
- To review the genetics, histopathology, disease mechanisms, and diagnostic criteria for TkA and GCA.
- To explore the debate on whether TkA and GCA are distinct diseases or variations of a single disease process.
Main Methods:
- Literature review of genetics, histopathology, and clinical presentations of TkA and GCA.
- Comparative analysis of diagnostic criteria and treatment approaches.
Main Results:
- TkA and GCA share significant histopathologic features and genetic factors.
- Despite distinct clinical profiles, overlapping presentations challenge clear differentiation.
- Current understanding remains incomplete regarding their precise relationship.
Conclusions:
- TkA and GCA exhibit considerable overlap, suggesting they may represent a spectrum of large vessel vasculitis.
- Further research is needed to definitively determine if they are distinct entities or variable manifestations of the same disease process.
Abstract:
There are multiple vasculitides which are distinguished based on multiple criteria, including size of affected vessels, distribution of vessels affected, histopathologic differences, genetic factors, and age at presentation. Takayasu's arteritis (TkA) and giant cell arteritis (GCA) are the two main medium to large vessel vasculitides. These vasculitides are associated with different racial predilections, vascular distributions, age groups, diagnostic criteria, and treatments. Nevertheless, the many shared histopathologic features, genetic factors, and overlap in presentation of these two diseases suggest that they may actually be variable presentations of the same disease process, i.e., large vessel vasculitis. This article will review the genetics, histopathology, disease mechanisms, and diagnostic criteria for both TkA and GCA. Overall, despite major advances our understanding of these two diseases, it is still debated whether these two large vessel vasculitides represent two distinct diseases processes or simply variations of the same disease.
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