Giant cell arteritis: A review of classification, pathophysiology, geoepidemiology and treatment

Abstract Giant cell arteritis is a chronic vasculitis affecting large and medium-sized arteries, most commonly the temporal and other cranial arteries. Temporal artery biopsy has long been the gold standard for establishing the diagnosis of giant cell arteritis. There is growing evidence that simult...

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Bibliographic Details
Published in:Autoimmunity reviews 2012-05, Vol.11 (6), p.A544-A554
Main Authors: Borchers, Andrea T, Gershwin, M. Eric
Format: Article
Language:English
Subjects:
Allergy and Immunology
Aneurysm
Aorta
Arteries
Arteritis
Biopsy
Color
Doppler effect
Epidemiology
Giant cells
Magnetic resonance imaging
Positron emission tomography
Reviews
Sex differences
Skull
Ultrasonography
Vasculitis
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Summary:Abstract Giant cell arteritis is a chronic vasculitis affecting large and medium-sized arteries, most commonly the temporal and other cranial arteries. Temporal artery biopsy has long been the gold standard for establishing the diagnosis of giant cell arteritis. There is growing evidence that simultaneous color Doppler and duplex ultrasonography of temporal arteries of GCA patients represents a valid alternative for this somewhat invasive procedure. Ultrasonography and other imaging modalities such as magnetic resonance imaging and positron emission tomography have also provided evidence that involvement of the aorta and its proximal branches is much more common in giant cell arteritis than previously appreciated; it will be important to clarify whether these patients need to be treated more aggressively. It has long been known that patients with giant cell arteritis face a markedly increased risk of developing aortic aneurysms and of dying from aortic dissection. This raises important questions as to whether patients should be screened regularly for extra-cranial large-vessel involvement and whether and how treatment of patients with positive screening results should be adjusted. In this review we discuss the pathophysiology of this disease and also the issues of epidemiology and sex differences.
ISSN:1568-9972
1568-9972
DOI:10.1016/j.autrev.2012.01.003