Petitpierre Stéphanie, Bart Pierre-Alexandre, Leimgruber Annette, Spertini François, Prior John, Spertini F
Service d'immunologie et d'allergie CHUV, 1011 Lausanne.
Rev Med Suisse. 2007 Apr 25;3(108):1056-60, 1062-3.
Giant cell arteritis (GCA) and Takayasu arteritis (TA) are both chronic granulomatous vasculitis of unknown aetiology that involve large vessels. Signs and symptoms are related to the affected vessels: the primary branches of the aorta in TA and the extra-cranial branches of the external carotid artery in GCA. TA affects women under 40 of all ethnic origins with a greater prevalence in Asia, whereas GCA affects elderly of caucasian ancestry. In both diseases the diagnosis and follow up are rendered difficult by the absence of specific marker but advances in imaging technologies such as angio-MRI and PET/CT are very promising. Corticosteroids still represent the basis of treatment, most often alone in GCA and usually in association with another immunosuppressive drug in TA.
巨细胞动脉炎(GCA)和大动脉炎(TA)均为病因不明的慢性肉芽肿性血管炎,累及大血管。其体征和症状与受累血管相关:TA累及主动脉的主要分支,GCA累及颈外动脉的颅外分支。TA影响所有种族40岁以下女性,在亚洲患病率更高,而GCA影响白种人血统的老年人。在这两种疾病中,由于缺乏特异性标志物,诊断和随访都很困难,但血管造影磁共振成像(angio-MRI)和正电子发射断层显像/X线计算机体层成像(PET/CT)等成像技术的进展很有前景。糖皮质激素仍然是治疗的基础,在GCA中大多单独使用,在TA中通常与另一种免疫抑制药物联合使用。