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Large vessel giant cell arteritis

Kornelis S M van der Geest1, Maria Sandovici1, Thorsten A Bley2

  • 1Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.

The Lancet. Rheumatology
|April 4, 2024
PubMed

Insights

Giant cell arteritis primarily affects those over 50. Large vessel giant cell arteritis, impacting the aorta, is often missed and requires advanced imaging for diagnosis and monitoring.

Area of Science:

  • Rheumatology
  • Internal Medicine
  • Vascular Medicine

Background:

  • Giant cell arteritis (GCA) is the most common systemic vasculitis in individuals over 50.
  • Large vessel GCA (LV-GCA) involves the aorta and its branches, potentially occurring with or without cranial GCA.
  • LV-GCA often presents with non-specific constitutional symptoms, leading to delayed diagnosis.

Purpose of the Study:

  • To define the large vessel subset of giant cell arteritis.
  • To summarize the clinical challenges associated with LV-GCA.
  • To identify future research directions for LV-GCA management.

Main Methods:

  • Review of existing literature and clinical data on LV-GCA.
  • Discussion of diagnostic imaging modalities including ultrasonography, MRA, CTA, and PET-CT.
  • Analysis of current understanding of LV-GCA presentation and complications.

Main Results:

  • LV-GCA is frequently overlooked, necessitating specific imaging for exclusion.
  • Imaging (MRA, CTA) is vital for detecting aortic aneurysms during follow-up.
  • The role of imaging in treatment monitoring requires further investigation.

Conclusions:

  • LV-GCA represents a distinct clinical challenge within GCA.
  • Early and accurate diagnosis through advanced imaging is crucial.
  • Further research is needed to optimize the management and monitoring of LV-GCA.

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