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The Diagnosis and Treatment of Giant Cell Arteritis
Zitieren Sie bitte immer diese URN: urn:nbn:de:bvb:20-opus-131676
- Background: Giant cell arteritis (GCA) is the most common systemic vasculitis in persons aged 50 and above (incidence, 3.5 per 100 000 per year). It affects cranial arteries, the aorta, and arteries elsewhere in the body, e.g., in the limbs. Methods: We selectively review the pertinent literature, including guidelines and recommendations from Germany and abroad. Results: The typical symptoms of new-onset GCA are bi-temporal headaches, jaw claudiacation, scalp tenderness, visual disturbances, systemic symptoms such as fever and weight loss,Background: Giant cell arteritis (GCA) is the most common systemic vasculitis in persons aged 50 and above (incidence, 3.5 per 100 000 per year). It affects cranial arteries, the aorta, and arteries elsewhere in the body, e.g., in the limbs. Methods: We selectively review the pertinent literature, including guidelines and recommendations from Germany and abroad. Results: The typical symptoms of new-onset GCA are bi-temporal headaches, jaw claudiacation, scalp tenderness, visual disturbances, systemic symptoms such as fever and weight loss, and polymyalgia. The diagnostic assessment comprises laboratory testing (erythrocyte sedimentation rate, C-reactive protein), imaging studies (duplex sonography, high-resolution magnetic resonance imaging, positron-emission tomography), and temporal artery biopsy. The standard treatment is with corticosteroids (adverse effects: diabetes mellitus, osteoporosis, cataract, arterial hypertension). A meta-analysis of three randomized controlled trials led to a recommendation for treatment with methotrexate to lower the recurrence rate and spare steroids. Patients for whom methotrexate is contraindicated or who cannot tolerate the drug can be treated with azathioprine instead. Conclusion: Giant cell arteritis, if untreated, progresses to involve the aorta and its collateral branches, leading to various complications. Late diagnosis and treatment can have serious consequences, including irreversible loss of visual function.…
Autor(en): | Thomas Ness, Thorsten A. Bley, Wolfgang A. Schmidt, Peter Lamprecht |
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URN: | urn:nbn:de:bvb:20-opus-131676 |
Dokumentart: | Artikel / Aufsatz in einer Zeitschrift |
Institute der Universität: | Medizinische Fakultät / Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) |
Sprache der Veröffentlichung: | Englisch |
Titel des übergeordneten Werkes / der Zeitschrift (Englisch): | Deutsches Ärzteblatt International |
Erscheinungsjahr: | 2013 |
Band / Jahrgang: | 110 |
Heft / Ausgabe: | 21 |
Seitenangabe: | 376–86 |
Originalveröffentlichung / Quelle: | Deutsches Ärzteblatt International 2013; 110(21): 376–86. DOI: 10.3238/arztebl.2013.0376 |
DOI: | https://doi.org/10.3238/arztebl.2013.0376 |
Allgemeine fachliche Zuordnung (DDC-Klassifikation): | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Freie Schlagwort(e): | arteriitis temporal arteriitis; c-reactive protein; complication aortic-aneurysm; corticosteroid treatment; double-blind; erythrocyte sedimentation-rate; large-vessel vasculitis; ocular manifestations; polymyalgia-rheomatica; systemic vasculitides |
Datum der Freischaltung: | 23.05.2016 |
Lizenz (Deutsch): | Deutsches Urheberrecht |