Giant-cell arteritis.
OBJECTIVE
Giant-cell arteritis frequently poses diagnostic and therapeutic challenges. This article summarizes recent investigations concerning diagnosis and treatment of giant-cell arteritis.


RESULTS
Efforts to improve diagnostic accuracy have centered on serologic markers and imaging techniques. Although the erythrocyte-sedimentation rate, C-reactive protein, and platelet count continue to be the primary markers, others such as interleukin-6 and fibrinogen can provide additional information. High-resolution magnetic resonance imaging and angiography, fluorine-18-fluorodeoxyglucose positron emission tomography, and color Doppler ultrasonography can show findings relevant to the diagnosis of giant-cell arteritis. Recent inquiries suggest a steroid-sparing benefit from initiation of treatment with intravenous steroids. Adjunctive treatment with methotrexate may also provide this benefit. Aspirin appears to decrease likelihood of stroke or visual loss in giant-cell arteritis without increasing bleeding complications.


CONCLUSIONS
An expanded repertoire of imaging techniques and serologic markers may supply information relevant to the diagnosis of challenging cases of giant-cell arteritis. Treatment modifications, including initiation with intravenous steroids, or addition of methotrexate or aspirin to the regimen, may decrease morbidity from disease, corticosteroid treatment or both.
Hall
Jennifer K
JK
Neuroophthalmology Service, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA. jkhall30@hotmail.com
D001241:Aspirin / Q000627:therapeutic use; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D018810:Magnetic Resonance Angiography; D008727:Methotrexate / Q000627:therapeutic use; D010976:Platelet Count; D019275:Radiopharmaceuticals; D018615:Ultrasonography, Doppler, Color
D005938:Glucocorticoids; D015850:Interleukin-6; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005340:Fibrinogen; D002097:C-Reactive Protein; D001241:Aspirin; D008727:Methotrexate