Baltimore—Rheumatologists and meteorologists share more in common than you might suspect, said Dr. Rebecca Manno, assistant professor of medicine for the Division of Rheumatology at Johns Hopkins University, Baltimore, and assistant director of the Johns Hopkins Vasculitis Center. At a March 8 meeting of the Maryland Society for the Rheumatic Diseases, Dr. Manno used the weather as an analogy for understanding updates on classification, diagnosis and treatment of giant cell arteritis (GCA) and topics to watch for in the coming year.
Explore this issueMay 2018
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“This is an exciting and unprecedented time for GCA,” Dr. Manno said. “There have been incredible advances in the diagnosis and treatment of this potentially devastating disease, and these are directly affecting the lives of patients in a positive way.”
Classification & Diagnosis
Just as the categorization and naming of hurricanes is important in correctly identifying these phenomena, said Dr. Manno, so too is vasculitis nomenclature. The Revised International Chapel Hill Consensus Conference of 2012 identified GCA as one of two large-vessel vasculitides (the other being Takayasu’s arteritis), yet Dr. Manno pointed out that a large-vessel vasculitis, such as GCA, can also affect medium and small arteries. The term temporal arteritis, which is often used interchangeably with GCA, can be misleading both because other vasculitides, such as polyarteritis nodosa, can affect the temporal arteries and because exclusive large-vessel involvement may be seen in GCA even when temporal artery involvement is scant or absent.