Department of Neurology, Division of Neuro-Epidemiology, New York University School of Medicine, New York, NY 10016, USA; School of Public Health, City University of New York, New York, NY, USA.
Neurol Clin. 2019 May;37(2):335-344. doi: 10.1016/j.ncl.2019.01.008. Epub 2019 Mar 16.
"Giant cell arteritis (GCA) is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries comprising overlapping phenotypes of cranial arteritis and extracranial GCA. Vascular complications are generally due to delay in diagnosis and initiation of effective treatment. Advancements in MRI and MR angiography, computed tomography angiography, 18fluoro-deoxyglucose/PET, and color duplex ultrasonography have led to improved diagnosis. Corticosteroids are the mainstay of therapy in GCA; however, their use is associated with predictable and occasionally serious side effects. Biological agents are effective and safe corticosteroid-sparing agents in treating GCA. This article reviews the epidemiologic, clinicopathologic features, diagnosis, and treatment of GCA."
巨细胞动脉炎(GCA)是一种慢性、特发性、中大型动脉的肉芽肿性血管炎,包括颅动脉炎和颅外 GCA 的重叠表型。血管并发症通常是由于诊断和开始有效治疗的延迟所致。磁共振成像(MRI)和磁共振血管造影(MRA)、计算机断层扫描血管造影(CTA)、18 氟脱氧葡萄糖/正电子发射断层扫描(18F-FDG/PET)和彩色双功能超声的进步导致了诊断的改善。皮质类固醇是 GCA 的主要治疗药物;然而,它们的使用与可预测且偶尔严重的副作用有关。生物制剂是治疗 GCA 的有效和安全的皮质类固醇节约剂。本文综述了 GCA 的流行病学、临床病理特征、诊断和治疗。