title: New developments in giant cell arteritis.
abstract: Giant cell arteritis (GCA) is a medium-to-large vessel vasculitis with potentially sight- and life- threatening complications. Our understanding of the pathogenesis, diagnosis, and treatment of GCA has advanced rapidly in recent times. The validity of using the American College of Rheumatology guidelines for diagnosis of GCA in a clinical setting has been robustly challenged. Erythrocyte sedimentation rate, an important marker of inflammation, is lowered by the use of statins and nonsteroidal anti-inflammatory drugs. Conversely, it may be falsely elevated with a low hematocrit. Despite the emergence of new diagnostic modalities, temporal artery biopsy remains the gold standard. Evidence suggests that shorter biopsy lengths and biopsies done weeks to months after initiation of steroid therapy are still useful. New imaging techniques such as positron emission tomography have shown that vascular inflammation in GCA is more widespread than originally thought. GCA, Takayasu arteritis, and polymyalgia rheumatica are no longer thought to exist as distinct entities and are more likely parts of a spectrum of disease. A range of immunosuppressive drugs have been used in conjunction with corticosteroids to treat GCA. In particular, interleukin-6 inhibitors are showing promise as a therapy.
authors.affiliation: Department of Ophthalmology, Rutgers-New Jersey Medical School, New Jersey, USA; Department of Neurosciences, Rutgers-New Jersey Medical School, New Jersey, USA.
authors.forename: Larry
authors.initials: L
authors.lastname: Frohman
authors.affiliation: Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: Aaron B C
authors.initials: AB
authors.lastname: Wong
authors.affiliation: Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
authors.forename: Kaliopy
authors.initials: K
authors.lastname: Matheos
authors.affiliation: Department of Ophthalmology, Rutgers-New Jersey Medical School, New Jersey, USA.
authors.forename: Luis G
authors.initials: LG
authors.lastname: Leon-Alvarado
authors.affiliation: Department of Ophthalmology, University of Auckland, Auckland, New Zealand. Electronic address: helendm@gmail.com.
authors.forename: Helen V
authors.initials: HV
authors.lastname: Danesh-Meyer
mesh_terms: D001706:Biopsy; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D049268:Positron-Emission Tomography / Q000379:methods*; D013699:Temporal Arteries / Q000000981:diagnostic imaging*
chemical_list: D005938:Glucocorticoids
keywords: corticosteroids; diagnosis; giant cell arteritis; pathogenesis; temporal arteritis; therapy