title: Effect of glucocorticoid treatment on computed tomography angiography detected large-vessel inflammation in giant-cell arteritis. A prospective, longitudinal study.
abstract: Computed tomography angiography (CTA) detects signs of large-vessel vasculitis (LVV) in about 67.5% of patients with giant-cell arteritis (GCA) at the time of diagnosis and early aortic dilatation in 15%. The outcome of CTA-findings of LVV upon glucocorticoid treatment has not been prospectively evaluated. The aim of our study was to prospectively assess glucocorticoid-induced changes in CTA findings of LVV in patients with GCA. Forty biopsy-proven GCA patients evaluated by CTA at diagnosis were prospectively followed and scheduled a new CTA approximately after 1 year of treatment. Vessel wall thickening, diameter, and contrast enhancement of the aorta and its tributaries were evaluated. Results were compared to those obtained at the time of diagnosis. CTA was repeated to 35 patients after a median follow-up of 13.5 months (IQ25-75% 12.4-15.8). Arterial wall thickening was still present in 17 patients (68% of the patients who initially had LVV). The number of affected segments and wall thickness at various aortic segments significantly decreased and no patients developed new lesions, new aortic dilation or increase in previous dilation. Contrast enhancement disappeared in 15 (93.75%) of 16 patients in whom this finding could be assessed. Signs of LVV improve with treatment. While contrast enhancement resolves in the majority of patients, vessel wall thickening persists in two thirds. However, the number of affected aortic segments as well as aortic wall thickness significantly decreases. Longer follow-up is necessary to determine the clinical significance of persisting wall thickening and its relationship with relapses or subsequent development of aortic dilatation or large-vessel stenoses.
authors: From the Vasculitis Research Unit, Departments of Systemic Autoimmune Diseases (SP-G, IT-B, JH-R, MAA, GM, GE-F, MCC); Emergency Medicine (AG-M); and Radiology (JG-C, MS, PA), Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS).
authors: Sergio
authors: S
authors: Prieto-González
authors: Ana
authors: A
authors: García-Martínez
authors: Itziar
authors: I
authors: Tavera-Bahillo
authors: José
authors: J
authors: Hernández-Rodríguez
authors: José
authors: J
authors: Gutiérrez-Chacoff
authors: Marco A
authors: MA
authors: Alba
authors: Giuseppe
authors: G
authors: Murgia
authors: Georgina
authors: G
authors: Espígol-Frigolé
authors: Marcelo
authors: M
authors: Sánchez
authors: Pedro
authors: P
authors: Arguis
authors: Maria C
authors: MC
authors: Cid
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001011:Aorta / Q000503:physiopathology*; D005260:Female; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids
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