Giant Cell Arteritis and Takayasu Arteritis: Are they a different spectrum of the same disease?

O’Neill, Lorraine; Ponte, Cristina; Sznajd, J; Rodrigues, Anna Paula; Seeliger, Benjamin; Luqmani, Raashid

doi:10.1016/j.injr.2015.03.009

Cited by 8 publications

(6 citation statements)

References 79 publications

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“…Therefore, headache, jaw or tongue claudication, and scalp tenderness are not expected to occur in TAK, unlike stroke, which is more common in TAK compared to GCA. Although involvement of the aorta and its main branches is more typical for TAK, it should be noted that there is a subgroup of GCA presenting in this way, without cranial arteritis, as discussed above (64,73,74).…”

Section: Similarities and Differences Between Takayasu Arteritis And mentioning

confidence: 92%

“…Recently it has been shown that there are clear discrepancies between these two types of inflammation, including cytokine patterns and even responses to treatment. Although no definite boundaries exist, it may be suggested that the IL-6/Th17/ IL-17 pathway primarily drives systemic inflammation, while the IL-12/Th1/IFN-γ pathway dominates in vascular wall inflammation not only in TAK but also in GCA (48,64). Corticosteroid (CS) and immunosuppressive (IS) treatments initially suppress systemic inflammation, while longer treatment duration is required for the suppression of vascular inflammation.…”

Section: Systemic Inflammation Versus Vascular Wall Inflammation In Tmentioning

confidence: 99%

“…cytokine response patterns, are also different in TAK and GCA. In patients with TAK, serum levels of Th1 cytokines are easily suppressed, while Th17 cytokines are resistant (49,64). On the other hand, in patients with GCA, the Th17 pathway is rapidly suppressed, while the Th1 pathway (IFN-γ production) is relatively CS-resistant and responsible for ongoing vascular inflammation (75,76).…”

Section: Similarities and Differences Between Takayasu Arteritis And mentioning

confidence: 99%

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Takayasu arteritis: an update

Keser¹,

Aksu²,

Direskeneli³

2018

Turk J Med Sci

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Takayasu arteritis (TAK) is a challenging chronic, granulomatous, large-vessel systemic vasculitis, mostly due to difficulties in early diagnosis and assessing actual disease activity. Since there are no specific diagnostic laboratory tests, biomarkers, or autoantibodies, many patients experience considerable delay in diagnosis. Remembering the possibility of TAK together with the use of acute phase responses and appropriate imaging studies may be helpful for early diagnosis. Since there may be discrepancies between systemic and vascular wall inflammation, using only acute phase responses is not reliable in assessing current disease activity. Therefore, physical examination and new imaging findings should also be used to assess current disease activity. Despite its limitations, the Indian Takayasu Clinical Activity Score (ITAS2010) may also be helpful for this purpose. The rationale of medical treatment is to suppress both vascular and systemic inflammation with appropriate systemic immunosuppression, including corticosteroids and conventional immunosuppressive agents. In cases of refractory disease activity, leflunomide and biologic agents such as TNF inhibitors and tocilizumab may be tried. In selected cases with persistent lesions that cannot be reversed with medical treatment, endovascular interventions including balloon angioplasty, stent and stent graft replacement, or surgery may be tried. However, such procedures should be performed after suppression of inflammation, i.e. during inactive disease. Prognosis of TAK is probably getting better with lower mortality rates reported in recent years, probably due to the use of more effective medical treatments as well as the use of endovascular interventions when necessary and available.

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Section: Similarities and Differences Between Takayasu Arteritis And mentioning

confidence: 92%

Section: Systemic Inflammation Versus Vascular Wall Inflammation In Tmentioning

confidence: 99%

Section: Similarities and Differences Between Takayasu Arteritis And mentioning

confidence: 99%

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Takayasu arteritis: an update

Keser¹,

Aksu²,

Direskeneli³

2018

Turk J Med Sci

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“…This subtype is hard to differentiate from Takayasu arteritis, but they may differentiate by the type of aortic involvement. Further studies are needed, in order to fully understand and to define the large spectrum of vasculitides (7,8).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic dilemmas in a case of early-onset large vessel vasculitis

Ciotoracu¹,

Ramba²,

Pana³

et al. 2019

Ro J Rheumatol.

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Vasculitides are inflammatory disorders which affect the blood vessels. There are three major categories of vasculitides depending on the size of the injured vessels. Although each category can affect any size artery, usually large vessel vasculitis affects large arteries. Takayasu arteritis and Giant Cell arteritis are known to be the two main types of large vessel arteritis. We present the case of a patient with a delayed diagnosis of Takayasu disease who sequentially develops a series of complications. The atypical evolution of the disease confirms once again the complexity of the vasculitic disorders and raises questions about the understanding of their pathophysiologic mechanisms.

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“…The link between the genetics and the etio‐pathology also needs clarification. T lymphocytes are implicated in both but there are clear differences between TA and GCA, although immuno‐pathogenic mechanisms are not fully elucidated for either . Interleukin (IL)‐12 driving the differentiation of TH1 cells producing interferon gamma (IFN‐γ) is prominently involved.…”

mentioning

confidence: 99%

Takayasu arteritis: A distinct syndrome of large vessel vasculitis: A view point by late Professor Paul Bacon

Misra

2019

Int J of Rheum Dis

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Takayasu arteritis (TA), despite being classified as a large vessel vasculitis, has distinct genetic, pathological and clinical features as compared to giant cell arteritis. It is a rare disease seen more commonly in Asian countries. The challenge lies in assessing the degree of inflammation in a narrowed vessel and immunosuppressive therapy improves inflammatory features but is unable to open up an occluded vessel. It may have a positive effect on retarding further occlusion. Like antineutrophil cytoplasmic antibody-associated vas-

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Giant Cell Arteritis and Takayasu Arteritis: Are they a different spectrum of the same disease?

Cited by 8 publications

References 79 publications

Takayasu arteritis: an update

Takayasu arteritis: an update

Diagnostic dilemmas in a case of early-onset large vessel vasculitis

Takayasu arteritis: A distinct syndrome of large vessel vasculitis: A view point by late Professor Paul Bacon

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