SHOULD PATIENTS WITH GIANT CELL ARTERITIS BE TESTED FOR AORTIC ANEURYSMS?

Marcin Milchert, Marek Brzosko

Abstract


Aortitis is one of the manifestations of giant cell arteritis (GCA) and is included in its definition. There is a significantly increased risk of aortic aneurysm formation in GCA patients. In some GCA patients aortic aneurysm dissection is diagnosed only in autopsy. Monitoring of these patients, especially in long lasting disease, requires a doctor’s awareness of the possibility of aneurysm formation and aortic aneurysm dissection. Based on the available reports it cannot be confirmed whether intensification of aortitis treatment in GCA prevents the development of aneurysms. This article presents an overview of the available literature and our own experience on a rational diagnosis of inflammation and aneurysms of the aorta in GCA, as well as the prospects for its prevention.

Keywords


giant cell arteritis; aortic aneurysm; computed tomography

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References


Jennette J.C., Falk R.J., Bacon P.A., Basu N., Cid M.C., Ferrario F. et al.: 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013, 65, 1–11.

Milchert M., Brzosko M.: Olbrzymiokomórkowe zapalenie tętnic i polimialgia reumatyczna. In: Reumatologia 2010/2011 nowe trendy. Ed: P. Wiland. Wyd. Termedia, Poznań 2011.

Milchert M., Brzosko M.: Olbrzymiokomórkowe zapalenie tętnic. In: Reumatologia kliniczna. Ed. M. Brzosko. Wyd. Pom. Uniw. Med. w Szczecinie, Szczecin 2010, 211–214.

Prieto‑González S., Arguis P., García‑Martínez A., Espígol‑Frigolé G., Tavera‑Bahillo I., Butjosa M. et al.: Large vessel involvement in biopsy‑proven giant cell arteritis: prospective study in 40 newly diagnosed patients using CT angiography. Ann Rheum Dis. 2012, 71, 1170–1176.

Evans J.M., O’Fallon W.M., Hunder G.G.: Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population‑based study. Ann Intern Med. 1995, 122, 502–507.

Robson J.C., Kiran A., Maskell J., Hutchings A., Arden N., Dasgupta B. et al.: The relative risk of aortic aneurysm in patients with giant cell arteritis compared with the general population of the UK. Ann Rheum Dis. 2015, 74 (1), 129–135.

Kermani T.A., Warrington K.J., Crowson C.S., Ytterberg S.R., Hun‑ der G.G., Gabriel S.E. et al.: Large‑vessel involvement in giant cell arteritis: a population‑based cohort study of the incidence‑trends and prognosis. Ann Rheum Dis. 2013, 72, 1989–1994.

Mackie S.L., Hensor E.M., Morgan A.W., Pease C.T.: Should I send my patient with previous giant cell arteritis for imaging of the thoracic aorta? A systematic literature review and meta‑analysis. Ann Rheum Dis. 2014, 73, 143–148.

Schillaci G., Bartoloni E., Pucci G., Pirro M., Settimi L., Alunno A. et al.: Aortic stiffness is increased in polymyalgia rheumatica and improves after steroid treatment. Ann Rheum Dis. 2012, 71, 1151–1156.

Ohara N., Miyata T., Kurata A., Oshiro H., Sato O., Shigematsu H.: Ten years’ experience of aortic aneurysm associated with systemic lupus erythematosus. Eur J Vasc Endovasc Surg. 2000, 19, 288–293.

Sciascia S., Rossi D., Roccatello D.: Interleukin 6 blockade as steroid‑sparing treatment for 2 patients with giant cell arteritis. J Rheumatol. 2011, 38, 2080–2081.




DOI: https://doi.org/10.21164/pomjlifesci.29

Copyright (c) 2016 Marcin Milchert, Marek Brzosko

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/