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Updated: Jul 17, 2026

An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
06:35

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

Published on: February 8, 2019

Time to diagnosis in large vessel vasculitis: insights from a retrospective study at a tertiary rheumatology centre

Anna Kernder1, Pauline Bussmann2, Uta Kiltz2

  • 1Ruhr University Bochum, Rheumazentrum Ruhrgebiet, Bochum, Germany Anna.Kernder@elisabethgruppe.de.

RMD Open
|July 15, 2026
PubMed

Insights

Diagnosing large vessel vasculitis (LVV) takes longer for Takayasu arteritis (TAK) than giant cell arteritis (GCA). Typical cranial symptoms shorten diagnosis time, while aortic involvement and prior rheumatology consultations prolong it.

Area of Science:

  • Rheumatology
  • Vascular Medicine
  • Diagnostic Pathways

Background:

  • Large vessel vasculitis (LVV) encompasses conditions like giant cell arteritis (GCA) and Takayasu arteritis (TAK).
  • Timely diagnosis of LVV is critical to prevent irreversible organ damage and long-term complications.
  • Diagnostic delays in LVV can stem from complex presentations and varied referral patterns.

Purpose of the Study:

  • To analyze the diagnostic journey of patients with LVV.
  • To identify factors contributing to the time to diagnosis in GCA and TAK.
  • To assess the impact of referring medical specialties on diagnostic timelines.

Main Methods:

  • Retrospective single-center study of 501 patients diagnosed with GCA or TAK (2014-2025).
  • Data collection included clinical, laboratory, and referral information from medical records.
  • Multivariate Cox regression and Kaplan-Meier curves analyzed factors influencing time to diagnosis.

Main Results:

  • Median time to diagnosis was 89 days for GCA versus 245 days for TAK.
  • Typical cranial symptoms correlated with shorter diagnostic intervals (HR 1.27, p=0.022).
  • Aortic involvement prolonged diagnosis (HR 0.64, p<0.001), while ophthalmologist (HR 2.40, p=0.001) and cardiologist (HR 3.81, p=0.008) referrals expedited it. Prior rheumatology consultations were linked to delays (HR 0.73, p=0.004).

Conclusions:

  • Diagnostic delay in LVV is influenced by disease subtype and clinical features.
  • Takayasu arteritis diagnosis is significantly longer than GCA.
  • Enhanced awareness and optimized referral pathways, particularly involving ophthalmology and cardiology, are essential to reduce diagnostic delays and improve patient outcomes.
Abstract

Keywords:
EpidemiologyGiant Cell ArteritisVasculitis

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