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British Medical Journal May 1958
Topics: Aorta; Aortic Diseases; Arteritis; Disease; Takayasu Arteritis
PubMed: 13536470
DOI: No ID Found -
Proceedings of the Royal Society of... Dec 1946
Topics: Arteries; Arteritis; Giant Cell Arteritis; Humans; Inflammation; Occipital Bone; Temporal Arteries
PubMed: 19993455
DOI: No ID Found -
Annals of the Rheumatic Diseases Mar 2009To develop European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis.
OBJECTIVES
To develop European League Against Rheumatism (EULAR) recommendations for the management of large vessel vasculitis.
METHODS
An expert group (10 rheumatologists, 3 nephrologists, 2 immunolgists, 2 internists representing 8 European countries and the USA, a clinical epidemiologist and a representative from a drug regulatory agency) identified 10 topics for a systematic literature search through a modified Delphi technique. In accordance with standardised EULAR operating procedures, recommendations were derived for the management of large vessel vasculitis. In the absence of evidence, recommendations were formulated on the basis of a consensus opinion.
RESULTS
Seven recommendations were made relating to the assessment, investigation and treatment of patients with large vessel vasculitis. The strength of recommendations was restricted by the low level of evidence and EULAR standardised operating procedures.
CONCLUSIONS
On the basis of evidence and expert consensus, management recommendations for large vessel vasculitis have been formulated and are commended for use in everyday clinical practice.
Topics: Aspirin; Drug Monitoring; Drug Therapy, Combination; Evidence-Based Medicine; Giant Cell Arteritis; Glucocorticoids; Humans; Immunosuppressive Agents; Inflammation Mediators; Takayasu Arteritis; Vasculitis
PubMed: 18413441
DOI: 10.1136/ard.2008.088351 -
Journal of the Royal Society of Medicine May 1993Inflammatory arterial disease is often insidious and associated with a substantial morbidity and mortality. Early recognition is vital. Patients with arteritis (n = 106)...
Inflammatory arterial disease is often insidious and associated with a substantial morbidity and mortality. Early recognition is vital. Patients with arteritis (n = 106) were studied and divided into five groups. Two of these were subgroups of giant cell arteritis classified by site into either cranial arteritis (66), or upper limb arteritis (7). Three other groups were identified; chronic periaortitis (with or without inflammatory aortic aneurysm) (7), polyarteritis nodosa (14), and small vessel arteritis (12). Clinicians are not sufficiently aware of arteritis and its many atypical presentations. Delay in management is associated with a significant morbidity and mortality. In this district serving 200,000 people at least one patient per month is seriously at risk from the disease. Improved outlook depends on early recognition of the clinical syndromes and rapid appropriate treatment.
Topics: Arteritis; Giant Cell Arteritis; Humans; Polyarteritis Nodosa; Prednisolone; Tomography, X-Ray Computed; Vasculitis
PubMed: 8099373
DOI: No ID Found -
The American Journal of Case Reports Jun 2023BACKGROUND Acute aortic insufficiency can be secondary to multiple conditions, including infective endocarditis, aortic root pathologies (eg, dissection, aortitis), or...
BACKGROUND Acute aortic insufficiency can be secondary to multiple conditions, including infective endocarditis, aortic root pathologies (eg, dissection, aortitis), or traumatic injury. Aortitis involves a broad spectrum of disorders characterized by inflammatory changes in the aortic wall. This pathology can be subsequently classified depending on its etiology into inflammatory and infectious causes. Large-vessel vasculitis (giant-cell arteritis, Takayasu arteritis, and IgG4-related vasculitis) is the most common non-infectious causes of aortitis. Giant-cell aortitis usually lacks the classic clinical findings of giant-cell arteritis such as headache, visual symptoms, or jaw claudication, which can be a diagnostic challenge. However, clinicians should have a high index of suspicion, since this pathology can evolve into potentially life-threatening conditions, including aortic aneurysm, aortic wall rupture, and aortic acute dissection. CASE REPORT We present a case of a 76-year-old woman who presented to the Emergency Department (ED) with shortness of breath associated with orthopnea, paroxysmal nocturnal dyspnea, and mild productive cough with white sputum. A transthoracic echocardiogram demonstrated reduced left ventricular ejection fraction, dilated left ventricle, and severe aortic insufficiency. Cardiac catheterization revealed mild non-obstructive coronary arteries and severe aortic regurgitation. The surgical pathology report of the portion of the aorta was consistent with giant-cell aortitis. CONCLUSIONS In this article, we present a case of giant-cell aortitis as an unusual etiology of acute aortic insufficiency, which is most probably under-detected in clinical practice. In addition to describing the case, we aim to highlight the importance of proper ascending aorta evaluation in patients presenting with new-onset aortic regurgitation and heart failure to prevent associated morbidity and mortality.
Topics: Female; Humans; Aged; Aortitis; Aortic Valve Insufficiency; Stroke Volume; Ventricular Function, Left; Aorta; Takayasu Arteritis; Aortic Rupture; Giant Cell Arteritis
PubMed: 37345235
DOI: 10.12659/AJCR.937836 -
Transplant Infectious Disease : An... Dec 2022The role of culturing the graft preservation fluid (PF) is controversial and its impact on graft arteritis development remains unclear. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The role of culturing the graft preservation fluid (PF) is controversial and its impact on graft arteritis development remains unclear.
METHODS
Systematic literature search retrieving observational studies comparing solid organ transplant (SOT) recipients with culture-positive PF versus culture-negative PF. The quality of included studies was independently assessed according to the ROBINS-I tool for observational studies. Meta-analysis was performed using Mantel-Haenszel random-effect models. Graft site arteritis within 180 days from transplant was selected as the primary outcome.
RESULTS
Twenty-one observational studies (N = 2208 positive PF vs. 4458 negative) were included. Among positive PF, 857 (38.8%) were classified as high-risk group pathogens and 1351 (61.2%) as low-risk pathogens. Low-risk and negative PF showed similar odds ratios. A significant higher risk of graft arteritis was found in SOT recipients with a PF yielding a high-risk pathogen (odds ratio [OR] 18.43, 95% confidence interval [CI] 7.83-43.40) compared to low-risk and negative PF, with low heterogeneity (I = 2.24%). Similar results were found considering separately high-risk bacteria (OR 12.02, 95%CI 4.88-29.60) and fungi (OR 71.00, 95%CI 28.07-179.56), with no heterogeneity (I = 0%), and in the subgroup analyses of the liver (OR 16.78, 95%CI 2.95-95.47) and kidney (OR 19.90, 95%CI 4.78-82.79) recipients. However, data about diagnostic features of graft arteritis were very limited, indeed for only 11 of the 93 events histological or microbiological results were reported.
CONCLUSIONS
Our results may support the performance of PF culturing and a preemptive diagnostic or therapeutic management upon isolation of high-risk pathogens. Further studies based on a reliable diagnosis of graft arteritis are needed.
Topics: Humans; Liver; Fungi; Bacteria; Arteritis
PubMed: 36271646
DOI: 10.1111/tid.13979 -
BMJ Case Reports May 2021
Topics: Abdominal Pain; Humans; Takayasu Arteritis
PubMed: 33962936
DOI: 10.1136/bcr-2021-243088 -
The Journal of Clinical Endocrinology... May 2020Primary aldosteronism (PA) confers an increased risk of cardiovascular disease (CVD), independent of blood pressure. Animal models have shown that aldosterone...
CONTEXT
Primary aldosteronism (PA) confers an increased risk of cardiovascular disease (CVD), independent of blood pressure. Animal models have shown that aldosterone accelerates atherosclerosis through proinflammatory changes in innate immune cells; human data are scarce.
OBJECTIVE
The objective of this article is to explore whether patients with PA have increased arterial wall inflammation, systemic inflammation, and reprogramming of monocytes.
DESIGN
A cross-sectional cohort study compared vascular inflammation on 2'-deoxy-2'-(18F)fluoro-D-glucose; (18F-FDG) positron emission tomography-computed tomography, systemic inflammation, and monocyte phenotypes and transcriptome between PA patients and controls.
SETTING
This study took place at Radboudumc and Rijnstate Hospital, the Netherlands.
PATIENTS
Fifteen patients with PA and 15 age-, sex-, and blood pressure-matched controls with essential hypertension (EHT) participated.
MAIN OUTCOME MEASURES AND RESULTS
PA patients displayed a higher arterial 18F-FDG uptake in the descending and abdominal aorta (P < .01, P < .05) and carotid and iliac arteries (both P < .01). In addition, bone marrow uptake was higher in PA patients (P < .05). Although PA patients had a higher monocyte-to-lymphocyte ratio (P < .05), systemic inflammatory markers, cytokine production capacity, and transcriptome of circulating monocytes did not differ. Monocyte-derived macrophages from PA patients expressed more TNFA; monocyte-derived macrophages of healthy donors cultured in PA serum displayed increased interleukin-6 and tumor necrosis factor-α production.
CONCLUSIONS
Because increased arterial wall inflammation is associated with accelerated atherogenesis and unstable plaques, this might importantly contribute to the increased CVD risk in PA patients. We did not observe inflammatory reprogramming of circulating monocytes. However, subtle inflammatory changes are present in the peripheral blood cell composition and monocyte transcriptome of PA patients, and in their monocyte-derived macrophages. Most likely, arterial inflammation in PA requires interaction between various cell types.
Topics: Adult; Aged; Arteries; Arteritis; Biomarkers; Case-Control Studies; Cross-Sectional Studies; Female; Fluorodeoxyglucose F18; Gene Expression Profiling; Hematopoiesis; Humans; Hyperaldosteronism; Inflammation; Male; Middle Aged; Monocytes; Netherlands; Positron Emission Tomography Computed Tomography
PubMed: 31875423
DOI: 10.1210/clinem/dgz306 -
Reumatologia Clinica Feb 2023
Topics: Humans; Giant Cell Arteritis; Aorta
PubMed: 36064887
DOI: 10.1016/j.reumae.2022.03.003 -
British Medical Journal May 1974In a retrospective survey we found that five (8.5%) out of 59 women with giant-cell arteritis had a history of thyrotoxicosis. This was significantly higher than in a...
In a retrospective survey we found that five (8.5%) out of 59 women with giant-cell arteritis had a history of thyrotoxicosis. This was significantly higher than in a control group of patients. Giant-cell arteritis and thyrotoxicosis occurred simultaneously in two cases. Knowledge of this association is of clinical use and is further evidence for an immunological basis for giant-cell arteritis.
Topics: Aged; Autoimmune Diseases; Biopsy; Female; Giant Cell Arteritis; Hematocrit; Humans; Hyperthyroidism; Hypothyroidism; Iodine Radioisotopes; Middle Aged; Prednisone; Retrospective Studies; Thyroid Hormones
PubMed: 4835298
DOI: 10.1136/bmj.2.5916.408