A Review of Primary Vasculitis Mimickers Based on the Chapel Hill Consensus Classification

Zarka, Farah; Veillette, Charles; Makhzoum, Jean-Paul

doi:10.1155/2020/8392542

Cited by 22 publications

(11 citation statements)

References 79 publications

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“…The TABUL study described optimal results when CDUS was performed on patients within 7 days of the start of glucocorticoids and, ideally, after they had received only a single dose of glucocorticoids. Additionally, vasculitides are heterogeneous diseases that can present with a range of symptoms, with many common diseases mimicking primary vasculitides [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience

Zarka¹,

Rhéaume²,

Belhocine³

et al. 2021

Rheumatology Advances in Practice

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Objectives The aim was to compare the accuracy of colour Doppler ultrasonography (CDUS) and temporal artery biopsy (TAB) to establish the final diagnosis of GCA and to determine how the GCA probability score (GCAPS) performs as a risk stratification tool. Methods Descriptive statistics were performed on a retrospective cohort of patients referred to our vasculitis referral centre between 1 July 2017 and 1 October 2020 for suspected GCA. CDUS, TAB, centre-specific TAB (vasculitis centre vs referring hospitals) and GCAPS were compared against the final diagnosis of GCA as determined by a GCA expert; CDUS was also compared with TAB results. Results Data from 198 patients were included: 60 patients with GCA and 138 patients without GCA. Sixty-two patients had a TAB. Using the final diagnosis by a GCA expert as a reference, the sensitivity, specificity, positive predictive value and negative predictive value were 93.3%, 98.5%, 96.6% and 97.1% for CDUS and 69.2%, 100%, 100% and 81.8% for TAB, respectively. The false-negative rate was 6.7% for CDUS and 30.8% for TAB. False-negative TAB mostly occurred when performed in referring hospitals (57.1%) as opposed to our vasculitis centre (21.1%). With a cut-off at 9.5 points, sensitivity for GCAPS was 98.3% and specificity 74.3%. Conclusion CDUS of the temporal and axillary arteries showed a high sensitivity and specificity and helped to diagnose GCA in patients with negative TAB. We validated that GCAPS is a useful clinical tool, with a score of <9.5 making the diagnosis of GCA improbable.

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Section: Discussionmentioning

confidence: 99%

Colour Doppler ultrasound and the giant cell arteritis probability score for the diagnosis of giant cell arteritis: a Canadian single-centre experience

Zarka¹,

Rhéaume²,

Belhocine³

et al. 2021

Rheumatology Advances in Practice

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“…The differential diagnosis for GCA include other vasculitis, other causes of amaurosis fugax, other conditions presenting with new onset headache, infections, Ig G4 disease, connective tissue disorders, lymphoproliferative diseases, amyloidosis and calciphylaxis. [160][161][162][163][164][165]…”

Section: Differential Diagnosismentioning

confidence: 99%

Diagnosis and management of giant cell arteritis: Major review

Simon

Ninan

Hissaria

2021

Clinical Exper Ophthalmology

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Giant cell arteritis is a medical emergency because of the high risk of irreversible blindness and cerebrovascular accidents. While elevated inflammatory markers, temporal artery biopsy and modern imaging modalities are useful diagnostic aids, thorough history taking and clinical acumen still remain key elements in establishing a timely diagnosis. Glucocorticoids are the cornerstone of treatment but are associated with high relapse rates and side effects. Targeted biologic agents may open up new treatment approaches in the future.

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“…Several mimics of GCA and PMR (Table 4) should be excluded via thorough history, physical examination, and investigations (Tables 2 and 3; Fig 2). 2,34,35 High erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are hallmarks of GCA. A small proportion of patients with GCA (<4%) have normal ESR and CRP.…”

Section: Gcamentioning

confidence: 99%