Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The incidences of temporal arteritis and polymyalgia rheumatica during a twelve year period were studied in different regions of Denmark. Data concerning the incidences of these diagnoses were obtained from two general hospitals from 1982 to 1994 and from the National Patient Register of all diagnoses from all hospitals in 13 of 16 Danish counties from 1982 til 1993. Data from all temporal artery biopsies in two counties were also obtained. Serological epidemiological surveillance data concerning infections causing epidemics in Denmark were obtained from Statens Serum Institut. Data concerning 10,818 patients from 13 counties and 2651 temporal artery biopsies from two counties were analysed. The incidence rate of temporal arteritis in the population aged 50 years and over was 20.4 per 100,000 (95% CI 19-23), and that of polymyalgia rheumatica 41.3 per 100,000 (95% CI 30-67). Significantly higher incidence rates were found in locations with a high population density. The incidence rate of histologically proven temporal arteritis in two counties was 15.1 per 100,000 > 50 years (95% CI 11-20). Pronounced quarterly and annual variations of the incidence were found, with a clustering in five peaks. These cyclic fluctuations were seen simultaneously in several regions. Two periods with an increased incidence of temporal arteritis and polymyalgia rheumatica occurred in close relation to epidemics of Mycoplasma pneumoniae infection. Two peak incidence rates were partly related to epidemics of Parvovirus B19 and one peak to an epidemic of Chlamydia pneumoniae. The synchronous variations in the incidences of temporal arteritis and polymyalgia rheumatica recorded in several regions of Denmark strongly indicate that an environmental infectious factor influences the frequencies. The close concurrence with the above-mentioned epidemics suggests that temporal arteritis and polymyalgia rheumatica may be triggered by certain viral and/or bacterial agents.
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PMID:[Synchronous variations in the incidence of temporal arteritis and polymyalgia rheumatica in Danish counties. Association with epidemics of Mycoplasma pneumonia infection]. 922 71

It is a common clinical experience that the onset of the so called non infectious vasculitides is often preceded by upper respiratory tract symptoms. A specific agent is only occasionally recovered. We report five cases in Sweden with manifestations of vasculitis from different organs. In three of the five patients the onset was preceded by upper respiratory tract symptoms. All patients had serologic findings indicating Chlamydia pneumoniae infection and all required corticosteroid treatment for symptomatic recovery. One was diagnosed as an aseptic meningitis. Another was diagnosed as a cerebral arteritis, probably a variant of a giant cell arteritis. A third patient had symptoms similar to a polymyalgia rheumatica engaging the thighs. Two patients had an acute myocardial infarction. One of them had Cogan's syndrome. The other also had pulmonary and hepatic engagement and an elevated level of anti basement membrane IgM antibodies, though not to the Goodpasture antigen. He had no renal involvement. The diagnosis of Chlamydia pneumoniae infection was based on the detection of species-specific IgA, IgG and IgM antibodies to Chlamydia pneumoniae using microimmunofluorescence technique, MIF. Four of the 5 cases exhibited a fourfold increase in antibody titers, and the fifth case was found to have high levels of IgG and IgA antibodies, suggesting recent infection. Investigations for other infectious agents were negative in all patients. The serologic findings in those patients are consistent with a pattern of reinfection with Chlamydia pneumoniae. We therefore suggest that reinfection with Chlamydia pneumoniae may induce isolated and systemic vasculitis in virtually any organ of the body.
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PMID:Reinfection with Chlamydia pneumoniae may induce isolated and systemic vasculitis in small and large vessels. 925 80

Little is known about the presence of common medical pathogens in the human oral cavity. Using a 16S rRNA-based PCR identification method, this study determined the occurrence of Porphyromonas asaccharolytica, Bacteroides fragilis and Chlamydia pneumoniae in subgingival plaque from 50 adults with advanced periodontitis. Each patient contributed samples from 3 deep periodontal pockets collected by paper points. The PCR primers were for P. asaccharolytica 5'-CTC TAG CTA GAG TGT ACT GG-3' and 5'-ATA GGG TTT ATA GAT TAG CTC TCT-3', for B. fragilis 5'-AAT GAT TCC GCA TGG TTT CAT TA-3' and 5'-GCG GTG ATT GCT CAC TGA CA-3', and for C. pneumoniae 5'- TGA CAA CTG TAG AAA TAC AGC-3' and 5'-CGC CTC TCT CCT ATA AAT-3'. The primers yielded a single amplicon with the respective reference strains and produced no amplicon with colonies of 25 groups of oral organisms. None of the three test species were detected in any of the 50 pooled subgingival samples tested. P. asaccharyolytica, B. fragilis and C. pneumoniae do not seem to be part of the periodontopathic microbiota in humans.
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PMID:Absence of Porphyromonas asaccharolytica, Bacteroides fragilis and Chlamydia pneumoniae in human subgingival plaque. 957 14

In a recent report Chlamydia pneumoniae (C. pneumoniae), examined with both immunohistochemistry and polymerase chain reaction (PCR), was detected in positive temporal artery biopsies from patients with temporal arteritis (TA). Our aim was to examine whether C. pneumoniae could be detected in patients with TA recruited from a high endemic area of TA in southern Norway. Twenty paraffin-embedded temporal artery biopsies showing convincing inflammation in the vessel wall with lymphocytic infiltration (giant cells in 12 biopsies) from 20 patients with TA were examined for the presence of C. pneumoniae using an established PCR technique. All examined TA patients (mean age 74.4 (SD 7.5) years, 75% females) fulfilled the ACR-1990 criteria. C. pneumoniae was not detected in any of the biopsies. In conclusion, our results indicate that C. pneumoniae, at least in the population of southern Norway, does not have any pathogenetic role in TA.
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PMID:Chlamydia pneumoniae not detected in temporal artery biopsies from patients with temporal arteritis. 1077 27

Some arguments are in favor of the role of Chlamydia in the pathogenesis of atherosclerosis and some vasculitis. Illustrating this possible relation, we report the case of a patient developing consecutively a Chlamydia psittacci infection and a temporal arteritis. A 73-year-old woman, with no significant medical history, was hospitalized for constitutional symptoms. Three weeks before, she had described fever and sore throat of two days' duration. Since that time, she had remained exhausted and developed a mild intermittent claudication of the jaws. Clinical examination was poor. A biological inflammatory syndrome was noticed. Chest X-ray revealed bilateral interstitial opacities. The titer of anti-C. psittaci antibodies was significant (positive 1g G at 1/2048). Soon after initiation of doxycycline, a temporal arteritis biopsy was performed, due to the persistence of clinical symptoms and high inflammatory syndrome, conclusive for the diagnosis of temporal arteritis. Corticotherapy was added to antibiotic therapy, resulting in the decrease of inflammatory syndrome and an improvement in the general status of the patient. X-ray opacities decreased in three weeks. Serological control after three months showed a decrease of the titer of anti-C. psittacci antibodies to 1/256, confirming the initial diagnosis of Chlamydia pneumopathy. Our observation could provide one more argument for the role of bacteria-like Chlamydia in the pathogenesis of vascular diseases. Prospective seroepidemiological and molecular biology studies could allow us to clarify the association between Chlamydia infections and inflammatory vasculitis-like temporal arteritis.
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PMID:A possible association between Chlamydiae psittacci infection and temporal arteritis. 1119 20

A 37 year-old man who developed a fatal middle cerebral territory infarct was found at autopsy, to have widespread granulomatous angiitis involving meningeal and intracranial--extracerebral vessels but not intracerebral vessels or other extra-cranial vessels. The findings are unique and overlap with those of granulomatous angiitis of the nervous system (GANS) and classic giant cell arteritis (GCA). A possible precipitant for this devastating illness was a recent Chlamydia infection. The salient clinical and pathologic differences between GANS and GCA of the nervous system are discussed.
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PMID:Intracranial giant cell arteritis with fatal middle cerebral artery territory infarct. 1290 57

The etiology of giant cell arteritis and polymyalgia rheumatica remains unknown, although the HLA-DR4 group and the pre-existence of a degenerative vascular disease are confirmed risk factors. The incidence may vary between countries, but the North-South gradient should be considered with caution because of potential detection and collection bias. Infectious trigger factors have been looked for both at the epidemiological and biological level: annual, cyclic variations of incidence have been shown in Minnesota, seasonal variations in Scotland, France or Israel. The pre-existence of clinical, mainly respiratory, infection has been suggested in one study, but not confirmed afterwards. Simultaneous occurrence of peaks of GCA/PMR and respiratory infections have been observed in Denmark. Several viruses have been suspected as triggers and assessed by serological testing, PCR or immunostaining on temporal artery biopsies, or both techniques: the hepatitis B virus can be ruled out, as well as Herpes simplex 1 and 2, Herpes varicellae, Epstein-Barr virus and cytomegalovirus. Recent studies focused on parainfluenza virus, Parvovirus B19 and Chlamydia pneumoniae. Immunological studies suggest, at the origin of the inflammatory reaction leading to the typical pathological features of giant cell arteritis, the existence of a triggering antigen of unknown nature activating T-cells in the artery wall.
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PMID:Is giant cell arteritis an infectious disease? Biological and epidemiological evidence. 1561 51

Chlamydia pneumoniae has recently been implicated in the pathogenesis of several neurological diseases. As an intracellular parasite with its unusual life cycle it is able to circumvent the immune system and to persist in the organism. It has the ability to modify the function of the infected cell and supposedly induce autoimmune reactions. These properties can make it pathogenic in several chronic neurological diseases including multiple sclerosis, atherosclerosis, stroke, Alzheimer dementia and giant cell arteritis. The evaluation of the available, often contradictory, data that are based on various different methods is not easy. The importance of the issue is enhanced by the potential need for antibiotic treatment.
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PMID:[The significance of Chlamydia pneumoniae in selected neurologic disorders]. 1649 68

The possibility of infectious triggers stimulating the development of inflammatory vascular diseases has generated much recent interest. This study uses PCR to detect the presence of Chlamydia pneumoniae, parvovirus B19 and all the human herpes viruses except HHV8 in temporal artery biopsy specimens. Samples from 37 temporal artery biopsies with histological evidence of arteritis and 66 samples from histologically negative temporal artery biopsies, all from different patients, were negative for C. pneumoniae, HSV, VZV, EBV, and HHV7 DNA. Two of the 37 histologically positive specimens were positive for HHV6, another two for CMV and a further two for parvovirus B19 DNA. Parvovirus B19 DNA was also detected in five histologically negative biopsies, one positive for HCMV DNA and a further one was positive for HHV6 DNA. There is no statistically significant difference to the presence of virus DNA in the two types of specimens (P = 0.538). This study does not support a role for C. pneumoniae, parvovirus B19 or human herpes viruses in the pathogenesis of temporal arteritis.
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PMID:Infection and temporal arteritis: a PCR-based study to detect pathogens in temporal artery biopsy specimens. 1820 26

Autoimmune diseases have several etiologies. Acute Chlamydia pneumoniae (C. pneumoniae) infection may be involved in the pathogenesis of several autoimmune diseases. In this study, 82 patients with several autoimmune diseases and 70 controls were enrolled, and acute C. pneumoniae infection has been evaluated by monitoring the levels of IgM antibody. Chlamydia pneumoniae IgM positive results were observed in 29% (P < 0.05) of the patients with several autoimmune diseases and in 10% of the controls. Chlamydia pneumoniae IgM positive cases were more frequent among the patients with rheumatoid arthritis (RA; 30%, P < 0.05), systemic lupus erythematosus (SLE; 28.0%, P < 0.05), dermatomyositis/polymyositis (23%, NS), myeloperoxidase-antineutrophil cytoplasmic autoantibody (MPO-ANCA)-associated vasculitis (33%, NS), adult onset of Still's disease (29%, NS) and giant cell arteritis/Takayasu arteritis (50%, NS) than among the controls. This positive frequency was statistically significant in RA and SLE. These results suggest that acute C. pneumoniae infection is probably involved in the pathogenesis of autoimmune diseases.
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PMID:Acute Chlamydia pneumoniae infection in the pathogenesis of autoimmune diseases. 1976 92


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