Giant cell arteritis

Giant cell arteritis (GCA) is the most common vasculitis of older age. It usually affects the branches of carotid arteries, especially temporal and ophthalmic artery. In addition to genetic predisposition, environmental factors also contribute to the development of the disease. Interleukin 6 (IL-6),...

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Autores principales:	Dijana Perković, Simeon Grazio, Tatjana Kehler, Jadranka Morović Verglas, Srđan Novak, Višnja Prus, Branimir Anić
Formato:	article
Lenguaje:	EN HR
Publicado:	Hrvatski liječnički zbor 2021
Materias:	giant cell arteritis – diagnosis drug therapy physiopathology; temporal arteries – pathology; interleukin-6 – blood physiology; c-reactive protein – analysis; polymyalgia rheumatica – complications; optic neuropathy ischemic – complications; glucocorticoids – therapeutic use; receptors interleukin-6 – antagonists and inhibitors; antibodies monoclonal Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/05a8d20fc6eb4c8789175f7489c33413
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spelling	oai:doaj.org-article:05a8d20fc6eb4c8789175f7489c334132021-12-03T09:33:08ZGiant cell arteritis10.26800/LV-143-3-4-90024-34771849-2177https://doaj.org/article/05a8d20fc6eb4c8789175f7489c334132021-04-01T00:00:00Zhttps://lijecnicki-vjesnik.hlz.hr/lijecnicki-vjesnik/arteritis-divovskih-stanica/https://doaj.org/toc/0024-3477https://doaj.org/toc/1849-2177Giant cell arteritis (GCA) is the most common vasculitis of older age. It usually affects the branches of carotid arteries, especially temporal and ophthalmic artery. In addition to genetic predisposition, environmental factors also contribute to the development of the disease. Interleukin 6 (IL-6), whose level correlates with inflammatory activity, is one of the key cytokines in the pathogenesis of the disease. Sterile inflammation of the artery wall with intimal hyperplasia and the development of occlusion leads to ischemia which is responsible for the onset of symptoms. The clinical picture is dominated by headache together with general symptoms. Sudden loss of vision may occur due to anterior ischemic optic neuropathy (AION). Frequently, signs of rheumatic polymyalgia are also present. Markedly high erythrocyte sedimentation rate (ESR) and elevated C reactive protein (CRP) are typical. The diagnosis is based on clinical and laboratory findings, temporal artery biopsy, and imaging examinations. Prompt diagnosis is crucial for timely and adequate treatment as well as prevention of early and late complications (blindness, arterial aneurysm or dissection). Until recently, treatment has been limited to the use of glucocorticoids and conventional immunomodulating drugs. This review paper outlines new therapeutic approaches arising from a better knowledge of pathophysiology. Insights from recent studies led to corrections of GCA treatment guidelines (as did the Croatian Society for Rheumatology in 2018) by recommending IL-6 inhibitor tocilizumab for patients with refractory or relapsing disease, and initially in patients at increased risk for complications. Clinical trials are underway that could deliver other therapeutic options in the near future.Dijana PerkovićSimeon GrazioTatjana KehlerJadranka Morović VerglasSrđan NovakVišnja PrusBranimir AnićHrvatski liječnički zborarticlegiant cell arteritis – diagnosisdrug therapyphysiopathology; temporal arteries – pathology; interleukin-6 – bloodphysiology; c-reactive protein – analysis; polymyalgia rheumatica – complications; optic neuropathyischemic – complications; glucocorticoids – therapeutic use; receptorsinterleukin-6 – antagonists and inhibitors; antibodiesmonoclonalMedicine (General)R5-920ENHRLiječnički vjesnik, Vol 143, Iss 3-4, Pp 130-138 (2021)
institution	DOAJ
collection	DOAJ
language	EN HR
topic	giant cell arteritis – diagnosis drug therapy physiopathology; temporal arteries – pathology; interleukin-6 – blood physiology; c-reactive protein – analysis; polymyalgia rheumatica – complications; optic neuropathy ischemic – complications; glucocorticoids – therapeutic use; receptors interleukin-6 – antagonists and inhibitors; antibodies monoclonal Medicine (General) R5-920
spellingShingle	giant cell arteritis – diagnosis drug therapy physiopathology; temporal arteries – pathology; interleukin-6 – blood physiology; c-reactive protein – analysis; polymyalgia rheumatica – complications; optic neuropathy ischemic – complications; glucocorticoids – therapeutic use; receptors interleukin-6 – antagonists and inhibitors; antibodies monoclonal Medicine (General) R5-920 Dijana Perković Simeon Grazio Tatjana Kehler Jadranka Morović Verglas Srđan Novak Višnja Prus Branimir Anić Giant cell arteritis
description	Giant cell arteritis (GCA) is the most common vasculitis of older age. It usually affects the branches of carotid arteries, especially temporal and ophthalmic artery. In addition to genetic predisposition, environmental factors also contribute to the development of the disease. Interleukin 6 (IL-6), whose level correlates with inflammatory activity, is one of the key cytokines in the pathogenesis of the disease. Sterile inflammation of the artery wall with intimal hyperplasia and the development of occlusion leads to ischemia which is responsible for the onset of symptoms. The clinical picture is dominated by headache together with general symptoms. Sudden loss of vision may occur due to anterior ischemic optic neuropathy (AION). Frequently, signs of rheumatic polymyalgia are also present. Markedly high erythrocyte sedimentation rate (ESR) and elevated C reactive protein (CRP) are typical. The diagnosis is based on clinical and laboratory findings, temporal artery biopsy, and imaging examinations. Prompt diagnosis is crucial for timely and adequate treatment as well as prevention of early and late complications (blindness, arterial aneurysm or dissection). Until recently, treatment has been limited to the use of glucocorticoids and conventional immunomodulating drugs. This review paper outlines new therapeutic approaches arising from a better knowledge of pathophysiology. Insights from recent studies led to corrections of GCA treatment guidelines (as did the Croatian Society for Rheumatology in 2018) by recommending IL-6 inhibitor tocilizumab for patients with refractory or relapsing disease, and initially in patients at increased risk for complications. Clinical trials are underway that could deliver other therapeutic options in the near future.
format	article
author	Dijana Perković Simeon Grazio Tatjana Kehler Jadranka Morović Verglas Srđan Novak Višnja Prus Branimir Anić
author_facet	Dijana Perković Simeon Grazio Tatjana Kehler Jadranka Morović Verglas Srđan Novak Višnja Prus Branimir Anić
author_sort	Dijana Perković
title	Giant cell arteritis
title_short	Giant cell arteritis
title_full	Giant cell arteritis
title_fullStr	Giant cell arteritis
title_full_unstemmed	Giant cell arteritis
title_sort	giant cell arteritis
publisher	Hrvatski liječnički zbor
publishDate	2021
url	https://doaj.org/article/05a8d20fc6eb4c8789175f7489c33413
work_keys_str_mv	AT dijanaperkovic giantcellarteritis AT simeongrazio giantcellarteritis AT tatjanakehler giantcellarteritis AT jadrankamorovicverglas giantcellarteritis AT srđannovak giantcellarteritis AT visnjaprus giantcellarteritis AT branimiranic giantcellarteritis
_version_	1718373308234203136

Giant cell arteritis

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