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    • "Giant cell arteritis (GCA) is a chronic inflammatory condition characterized by medium-and large-vessel granulomatous vasculitis , typically affecting adults older than 50 years of age [13]. Vascular complications of GCA include ischemic optic neuropathy, stroke, large-vessel stenosis, and aneurysm [14]. "
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    ABSTRACT: To investigate the association between giant cell arteritis (GCA) and risk of coronary artery disease (CAD). We conducted a systematic review and meta-analysis of observational studies that reported relative risks, hazard ratios, or standardized incidence ratios with 95% confidence interval comparing CAD risk in patients with GCA versus non-GCA controls. Pooled risk ratios and 95% confidence intervals were calculated using a random-effect, generic inverse variance of DerSimonian and Laird. Six studies with 10,868 patients with GCA and 245,323 controls were identified and included in our data analysis. The pooled risk ratio of CAD in patients with GCA was 1.51 and did not achieve statistical significance (95% CI: 0.88-2.61). The statistical heterogeneity was high with an I(2) of 97%. In contrast to other chronic systemic inflammatory disorders, our meta-analysis did not show any statistically significant increased risk of CAD among patients with GCA. Copyright © 2014 Elsevier Inc. All rights reserved.
    Seminars in Arthritis and Rheumatism 10/2014; 44(5). DOI:10.1016/j.semarthrit.2014.10.010 · 3.93 Impact Factor
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    • "By contrast, a correct diagnosis may become challenging when symptoms are nonspecific, given the wide range of clinical manifestations of GCA [3, 5, 44]. Currently, TAB is still the diagnostic standard of reference [1, 2], but its routine clinical application is hampered by low sensitivity with a high false-negative rate (15%–40%) [45–49] and the concrete risk of underdetection [1, 9–12, 50]. Furthermore, the involvement of the thoracic aorta or its main branches, which is present in more than 45% of newly diagnosed patients with GCA, is associated with a negative TAB in 50% of reported cases [20, 51–54]. "
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    ABSTRACT: Giant cell arteritis (GCA) is the most common vasculitis affecting medium and large vessels. It shows a close clinical association with polymyalgia rheumatica (PMR), a musculoskeletal inflammatory disorder, which is clinically characterized by girdles pain and stiffness. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is an effective tool for the diagnosis, grading, and follow-up of patients affected by GCA involving the aorta and its proximal branches, but the lack of a standardized method for the assessment of vascular inflammation remains a critical issue, potentially leading to misclassification. In our systematic review, including 19 original articles for a total of 442 GCA patients (with or without PMR symptoms) and 535 healthy controls, we described the different qualitative, semiquantitative and combined methods that have been proposed throughout the literature for assessing the presence and grading the severity of GCA-related vascular inflammation on 18F-FDG PET scans, focusing on the diagnostic performance and examining their respective advantages and limitations. The majority of the included studies adopted qualitative methods of PET image analysis, which are less sensitive but more specific than semiquantitative ones. Among the semiquantitative approaches, the aortic-to-blood pool uptake ratio of the aortic arch seems to be the most accurate method.
    BioMed Research International 09/2014; 2014:574248. DOI:10.1155/2014/574248 · 2.71 Impact Factor
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    • "inhabitants, with a peak of 200 cases/100.000 inhabitants, over 50 years of age [7]; a higher incidence is reported in extreme northern latitudes [8]; it is rare among the Afro-American population [9]; familial cases have been reported [10]. In 50–60% of patients, GCA is associated with the polymyalgia rheumatica (PR). "
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    ABSTRACT: Giant cell arteritis is a systemic vasculitis characterized by granulomatous inflammation of the aorta and its main vessels. Cardiovascular risk, both for arterial and venous thromboembolism, is increased in these patients, but the role of thromboprophylaxis is still debated. It should be suspected in elderly patients suffering from sudden onset severe headaches, jaw claudication, and visual disease. Early diagnosis is necessary because prognosis depends on the timeliness of treatment: this kind of arteritis can be complicated by vision loss and cerebrovascular strokes. Corticosteroids remain the cornerstone of the pharmacological treatment of GCA. Aspirin seems to be effective in cardiovascular prevention, while the use of anticoagulant therapy is controversial. Association with other rheumatological disease, particularly with polymyalgia rheumatica is well known, while possible association with antiphospholipid syndrome is not established. Large future trials may provide information about the optimal therapy. Other approaches with new drugs, such as TNF-alpha blockades, Il-6 and IL-1 blockade agents, need to be tested in larger trials.
    International Journal of Rheumatology 05/2014; 2014:806402. DOI:10.1155/2014/806402
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