Temporal Artery Vascular Diseases

Abstract

In the presence of temporal arteritis, clinicians often refer to the diagnosis of giant cell arteritis (GCA). However, differential diagnoses should also be evoked because other types of vascular diseases, vasculitis or not, may affect the temporal artery. Among vasculitis, Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis is probably the most common, and typically affects the peri-adventitial small vessel of the temporal artery and sometimes mimics giant cell arteritis, however, other symptoms are frequently associated and more specific of ANCA-associated vasculitis prompt a search for ANCA. The Immunoglobulin G4-related disease (IgG4-RD) can cause temporal arteritis as well. Some infections can also affect the temporal artery, primarily an infection caused by the varicella-zoster virus (VZV), which has an arterial tropism that may play a role in triggering giant cell arteritis. Drugs, mainly checkpoint inhibitors that are used to treat cancer, can also trigger giant cell arteritis. Furthermore, the temporal artery can be affected by diseases other than vasculitis such as atherosclerosis, calcyphilaxis, aneurysm, or arteriovenous fistula. In this review, these different diseases affecting the temporal artery are described.

Rapid-onset bilateral scalp ulceration with visual loss

“…GCA has no specific biological marker. 1 In our patient, the diagnosis was based on clinical and laboratory findings. It was confirmed by an ultrasound of the temporal artery.…”

“…The dose is gradually tapered once remission is achieved. 1,3 C. Topical steroids e Incorrect. Topical or intralesional corticosteroids may resolve localized areas of cutaneous involvement in cutaneous polyarteritis nodosa (a medium-sized vessel vasculitis).…”

“…It may be combined with systemic corticosteroids as initial treatment in newly diagnosed GCA patients already presenting corticosteroid-related adverse events (AE) or at high risk for such AE. 1,3 E. Methotrexate e Incorrect. Methotrexate has long been the corticosteroid-sparing drug for GCA.…”

“…It is characterized by symmetrical and bilateral aching and stiffness in the shoulders, neck, and pelvic girdle, particularly in the morning. 1 Abbreviations used: AE: adverse events GCA: giant cell arteritis SCC: squamous cell carcinoma…”

Fever Correlation with Erythrocyte Sedimentation Rate (ESR) and C-Reactive Protein (CRP) Concentrations in Patients with Isolated Polymyalgia Rheumatica (PMR): A Retrospective Comparison Study between Hospital and Out-of-Hospital Local Registries

“…On the other hand, fever or low-grade fever can be the onset manifestation in some PMR-mimicking diseases, such as infections and malignancies [ 11 , 12 , 13 , 14 , 15 ], or can be a warning signal for an association with a large-vessel vasculitis, named giant cell arteritis [GCA]). GCA, a granulomatous vasculitis affecting the aorta and its branches, may be associated with PMR in up to 20% of cases [ 16 , 17 , 18 , 19 , 20 ].…”