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Query: UMLS:C0039483 (giant cell arteritis)
 3,204 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Determining the cause of systemic vasculitis can be facilitated by a clinicopathologic classification of the syndrome. The considerations in differential diagnosis include periarteritis nodosa, leukocytoclastic angiitis (hypersensitivity angiitis, Schonlein-Henoch purpura, other disease-associated vasculitis), Wegener's granulomatosis, allergic granulomatosis (granulomatous angiitis), and giant cell arteritis.
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PMID:The spectrum of systemic vasculitis: a classification to aid diagnosis. 24 Jan 57

In this article, the author reviews some of the most common vasculitic disorders, including: polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, hypersensitivity vasculitis, Henoch-Schonlein purpura, giant cell arteritis, and Takayasu's arteritis. Information about the definition, general considerations, clinical findings, diagnostic tests, classification criteria, and treatment is included. The significance of early recognition of these disorders in the critical care area is discussed.
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PMID:Unraveling the mystery: clues to systemic vasculitic disorders. 749 66

In the early 1900s, von Pirquet first introduced the concept that antigen antibody complexes might cause disease. Since that time, systemic necrotizing vasculitis is believed to be a typical form of immune complex-mediated vasculitis and it may be found in many disorders associated with immunological abnormalities. In 1866, Kusmaul and Maier reported a case with multilesions of necrotizing vasculitis named as periarteritis nodosa which is now nominated as polyarteritis nodosa characterized by the presence of focal inflammatory lesions in small and medium-sized arteries. Besides polyarteritis nodosa, necrotizing vasculitis is frequently found in connective tissue diseases, especially in SLE and RA. Granulomatous vasculitis is a definitely different type of vasculitis from necrotizing vasculitis and known to be found in Wegener's granulomatosis. Whether or not granulomatous vasculitis is an immune complex-mediated disease is unknown, but it can be produced experimentally in several settings. In a experimental model of serum sickness, animals who are hyperimmune responders have widespread granulomatous lesions similar to Wegener's granulomatosis in histology. Intravenous injection of complete Freund's adjuvant in rabbits followed by intravenous administration of human IgM rheumatoid factor is capable of inducing a marked pulmonary granulomatous reaction. The relation of these observations to human Wegener's granulomatosis is uncertain, but the histology and location of the lesions are strikingly similar to human disease. Vasculitis involved in large and medium-sized arteries is seen in two different types of diseases known as temporal arteritis and Takayasu's arteritis. Circulating and tissue-bound immune complexes have been found in both conditions. Most common vasculitis in childhood is Schonlein-Henoch purpura in North America and Kawasaki disease in Japan.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Immune complex and vasculitis]. 793 75

The epidemiology of the systemic vasculitides is poorly documented. Many studies have been conducted from tertiary referral centers, with resulting problems of referral bias and uncertainty of denominator population, or have involved small populations. We have estimated the incidence of the major forms of systemic vasculitis in a stable, ethnically homogeneous population of 414,000 adults from 1988 to 1994. The overall annual incidence of systemic vasculitis (excluding giant cell arteritis) is 39/million (95% confidence intervals; ranging from 31 to 47). The annual incidence of Wegener's granulomatosis is 8.5/million (range, 5.2 to 12.9), Churg-Strauss syndrome 2.4/million (0.9 to 5.3), microscopic polyangiitis 2.4/million (0.9 to 5.3), adult Henoch-Schonlein purpura 1.2/million (0.3 to 3.5), and systemic rheumatoid vasculitis 12.5/million (8.5 to 17.7). These data suggest that the overall incidence of systemic vasculitis is greater than previously thought (10/million) with Wegener's granulomatosis and systemic rheumatoid vasculitis being the most common. Whether this represents a genuine increase in incidence or increased physician awareness is uncertain.
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PMID:Epidemiology of systemic vasculitis: changing incidence or definition? 852 88

In summary, systemic vasculitides constitute a heterogeneous group of overlapping diseases that are somewhat more common than previously considered. Although the causes of vasculitis are largely unknown, epidemiologic studies have implicated geographic, genetic, and environmental factors. Ethnicity, various genes such as those of the MHC, gender, and environmental factors seem to account for the different incidence rates of these syndromes. GCA is the most common vasculitis in elderly people from Western countries. Small-sized cutaneous vasculitides, particularly HSP in children and HV in adults, are also common diseases. Increased physician awareness and the routine use of ANCA tests may contribute to an increase in the recognition of conditions such as WG and MPA.
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PMID:Epidemiology of the vasculitides. 1172 61

Parvovirus B19 (B19) causes many clinical disorders, of which the most common are erythema infectiosum, aplastic crisis complicating chronic hemolytic anemia, and hydrops fetalis. In young adults, the skin eruption caused by B19 is accompanied with polyarthritis and polyarthralgia in 60% of the cases. The joint abnormalities predominate in the hands and feet and usually resolve within a week (range 2-21 d). Serological tests show IgM antibodies against B19, confirming the diagnosis of recent infection. Protracted polyarthritis occurs in some patients and seems associated with the DR4 histocompatibility alleles. Rheumatoid factors can be produced transiently in these patients. Other autoantibodies produced in the wake of B19 infection include anti-nuclear antibodies, anti-DNA, anti-SSA/SSB, and anti-phospholipids. Acute B19 infection can simulate early rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) (lupus-like eruption over the cheeks, cytopenia, etc.). In addition, there have been a few reports of erosive RA or SLE developing shortly after a B19 infection, with positive PCR tests for B19 DNA in synovial tissue or blood cells. Studies in large series indicate that B19 is probably an extremely rare cause of RA or SLE. Vasculitides affecting the small vessels (Henoch-Schonlein purpura, Wegener's granulomatosis), medium-sized vessels (periarteritis nodosa), and large vessels (giant cell arteritis) can occur after B19 infection. Here again, the number of clinical cases is small.
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PMID:Parvovirus B19 and autoimmune diseases. 1263 11

The vasculitides are conditions of unknown aetiology. Until recently, relatively little was known about their incidence and prevalence, but there are now increasing data, especially from Europe. These are conditions of the extremes of age. Kawasaki disease occurs predominately in Asian children, with a peak annual incidence of 90/100,000 children aged under 5 years. Henoch-Schonlein purpura has an incidence of 70/100,000 in those aged 4-7 years and is also more common in Asians. Primary systemic vasculitis has a peak incidence 6/100,000 in those aged 65-74 years. Giant cell arteritis is most common in Caucasians aged over 70 years, with an incidence of 53/100,000. Vasculitis has been associated with malignancy, the association being strongest between haematological malignancies and cutaneous vasculitis. There is occasionally a temporal association; failure to respond appropriately to therapy should prompt a search for malignancy. Lesions suspicious of malignancy should be biopsied even if the diagnosis of vasculitis has been histologically proven.
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PMID:What is known about the epidemiology of the vasculitides? 1585 91

The systemic vasculitides are heterogeneous conditions of unknown etiology characterized by inflammation and necrosis of different sized blood vessels. Wegener's Granulomatosis, microscopic polyangiitis, and Churg Strauss syndrome are associated with anti-neutrophil cytoplasmic antibodies and affect small and medium blood vessels. They are very rare in childhood and peak in the 65 to 70 year old age group. Wegener's Granulomatosis appears to be more common in the North of Europe compared with the South. All are more common in whites compared with other populations. Genetic and environmental factors, including infection, drugs, and silica, are important in etiology. Giant cell arteritis is predominantly a disease of whites over the age of 50. It appears more common in individuals with Nordic descent. Incidence may be increasing over time and cyclical variation in disease may reflect an infectious etiology. Takayasu arteritis is a disease of the aorta and its branches, however pulmonary and cardiac arteries may be involved. Patients are usually under 40-years of age at presentation and there are no apparent differences in incidence or clinical characteristics/aortic involvement across the globe. Kawasaki disease (KD) and Henoch-Schonlein purpura are diseases of children and rarely affect adults. Both have been reported to be more common in Asians than whites. The incidence of KD is higher in Japan and China compared with other regions. No definite trigger factors have been found, but KD has been linked to infection, house dust mite and chemicals, and Henoch-Schonlein purpura to a pesticide and drugs.
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PMID:Epidemiology of systemic vasculitis. 1604 29

Antiendothelial cell antibodies (AECA) have been detected in healthy individuals, as well as in autoimmune and systemic inflammatory diseases, including systemic vasculitides. AECA have been reported in large vessel vasculitides such as giant cell arteritis and Takayasu arteritis; medium-sized vessel vasculitides, such as polyarteritis nodosa related to hepatitis B virus infection and Kawasaki disease; and small-sized vessel vasculitides, such as Wegener's granulomatosis, microscopic polyangiitis, and Henoch-Schonlein purpura. In Takayasu arteritis and antineutrophil cytoplasm antibody-positive vasculitides, AECA have been reported to correlate with disease activity. A cell-based enzyme-linked immunosorbent assay (ELISA) using cultured human umbilical vein endothelial cells (HUVEC) represent one of the reference techniques for AECA detection, although flow cytometry and immunobloting have also been proposed. AECA might contribute to the pathogenesis of systemic vasculitides and vasculitis-associated diseases through (1) activation of endothelial cells (EC), (2) direct cytotoxic effect due to complement-dependent cytotoxicity or indirect cytotoxic effect secondary to antibody-dependent cytotoxicity, (3) induction of coagulation, (4) induction of apoptosis through the binding of phospholipids or heat-shock protein 60, and (5) induction of EC activation. None of the identified target antigens of AECA is specific for EC, and EC-specific target antigens of AECA remain to be identified in systemic vasculitides.
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PMID:Antiendothelial cells autoantibodies in vasculitis-associated systemic diseases. 1822 62

Vasculitis comprises a broad group of syndromes characterized by inflammation and necrosis on the walls of blood vessels, resulting in narrowing or occlusion of the lumen. The distribution of involved blood vessel varies considerably and serves as the basis for one classification of vasculitic syndromes: large vessels (Takayasu arteritis, giant cell arteritis); medium and small muscular arteries (polyarteritis nodosa, Churg-Strauss syndrome, Wegener's granulomatosis, vasculitis in rheumatic diseases); and small vessels ("hypersensitivity" vasculitis, Henoch-Schonlein purpura, microscopic polyangiitis, cryoglobulinemia). This article reviews medium and large vessel vasculitis and current treatment options; it also presents a comprehensive approach to diagnosing and treating patients with suspected cutaneous vasculitis.
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PMID:[Medium and large vessel vasculitis]. 1937 60


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