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.
Neuroophthalmology Service, Wills Eye Institute, Philadelphia, Pennsylvania 19107, USA. jkhall30@hotmail.com
Jennifer K
JK
Hall
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