The large vessel vasculitides were a major focus of the 21st International Vasculitis Workshop held in Barcelona in April. The biennial conference brings together specialists from multiple disciplines, including rheumatology, nephrology and immunology, to discuss cutting-edge vasculitis research. This article reviews important points regarding the pathogenesis, diagnosis and management of both giant cell arteritis and…
At the end of 2023, the Society for Cardiovascular Pathology (SCVP) published consensus guidelines on the diagnostic approach to temporal artery biopsy.1 Through this publication, SCVP hopes to bring more uniformity to the processing, interpretation and reporting of these specimens, taking into consideration the most up-to-date literature available. These guidelines have obvious impact on clinical…
Background/Purpose It has been reported that 20–50% of patients with polymyalgia rheumatica (PMR) have subclinical giant cell arteritis (GCA). The natural history of ultrasound-defined subclinical GCA in PMR is not known. Methods Twenty-five newly diagnosed PMR patients who met a clinical diagnosis for PMR, verified by two rheumatologists, were examined by ultrasound. All six branches…
Giant cell arteritis (GCA) is a granulomatous vasculitis of large- and medium-sized arteries, usually affecting the cranial branches of the aortic arch. It is the most common vasculitis, with the highest risk factor being age. Accurate diagnosis and prompt initiation of therapy are of great importance to prevent serious complications, with the most feared being…
We report on a 77-year-old patient who was diagnosed with giant cell arteritis (GCA) on histopathology of the submandibular gland and eventually went on to develop classic signs and symptoms of GCA. This observation highlights neck swelling as a rare initial presentation of GCA. Case Presentation A 77-year-old previously healthy man presented to his primary…
A large, international team of rheumatologists, geneticists, hematologists and other researchers has discovered a severe inflammatory syndrome linked to an acquired genetic mutation in the bone marrow of older men. The X-linked syndrome, they found, is caused by a somatic mutation in myeloid stem cells that hobbles the master regulator of a pathway tasked with…
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic condition characterized by pain and morning stiffness at the neck, shoulders and hip girdle. It can be associated with giant cell arteritis (GCA); in fact, the two disorders may represent a continuum of the same disease process. This case describes a patient who initially refused treatment for PMR…
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…
A proposed model to predict the risk of giant cell arteritis (GCA) prior to a temporal artery biopsy could help triage patients and guide decision making about the need for biopsy or monitoring (see Figure 1). There’s no specific biomarker for GCA, and GCA can be a “diagnostic conundrum, especially when it presents in an…
A recent study, conducted by the Vasculitis Clinical Research Consortium and funded by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), examined whether the addition of abatacept, a drug that affects T cell activation, to standard prednisone treatment could reduce the risk of relapse in patients with giant cell arteritis (GCA).1 Although…