Department of Internal Medicine, University Hospital of Nantes, Nantes University, Nantes, France.
Department of Internal Medicine and Clinical Immunology, University Hospital of Dijon, University of Burgundy, Dijon, France.
Scand J Rheumatol. 2019 Nov;48(6):474-481. doi: 10.1080/03009742.2019.1661011.
: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB).: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a French multicentre database. They all met at least three American College of Rheumatology criteria for the diagnosis of GCA. Aortitis was defined by aortic wall thickening > 2 mm on computed tomography scan and/or an aortic aneurysm, associated with an inflammatory syndrome. Patients were divided into two groups [positive and negative TAB (TAB+, TAB-)], which were compared regarding aortic imaging characteristics and aortic events, at aortitis diagnosis and during follow-up.: We included 56 patients with TAB+ (70%) and 24 with TAB- (30%). At aortitis diagnosis, patients with TAB- were significantly younger than those with TAB+ (67.7 ± 9 vs 72.3 ± 7 years, p = 0.022). Initial clinical signs of GCA, inflammatory parameters, and glucocorticoid therapy were similar in both groups. Coronary artery disease and/or lower limb peripheral arterial disease was more frequent in TAB- patients (25% vs 5.3%, p = 0.018). Aortic wall thickness and type of aortic involvement were not significantly different between groups. Diffuse arterial involvement from the aortic arch was more frequent in TAB- patients (29.1 vs 8.9%, p = 0.03). There were no differences between the groups regarding overall, aneurism-free, relapse-free, and aortic event-free survival.: Among patients with GCA-related aortitis, those with TAB- are characterized by younger age and increased frequency of diffuse arterial involvement from the aortic arch compared to those with TAB+, without significant differences in terms of prognosis.
: 比较根据颞动脉活检(TAB)结果的巨细胞动脉炎(GCA)相关大动脉炎的临床表现和结局:从法国多中心数据库中回顾性纳入 2000 年至 2017 年间诊断为 GCA 相关大动脉炎且接受 TAB 的患者。所有患者均符合美国风湿病学会(ACR)诊断 GCA 的至少三项标准。通过计算机断层扫描(CT)扫描和/或主动脉瘤确定主动脉壁增厚>2mm 定义为大动脉炎,伴有炎症综合征。将患者分为两组[TAB+(TAB+,TAB-)],比较两组的主动脉影像学特征和主动脉事件,在大动脉炎诊断时和随访期间。:我们纳入了 56 例 TAB+(70%)和 24 例 TAB-(30%)患者。在大动脉炎诊断时,TAB-患者明显比 TAB+患者年轻(67.7±9 岁比 72.3±7 岁,p=0.022)。两组的初始 GCA 临床症状、炎症参数和糖皮质激素治疗相似。TAB-患者的冠状动脉疾病和/或下肢外周动脉疾病更为常见(25%比 5.3%,p=0.018)。两组之间主动脉壁厚度和主动脉受累类型无显著差异。TAB-患者弥漫性主动脉弓受累更为常见(29.1%比 8.9%,p=0.03)。两组在总体生存率、无瘤生存率、无复发生存率和无主动脉事件生存率方面无差异。:在 GCA 相关大动脉炎患者中,与 TAB+患者相比,TAB-患者的特点是年龄较小,主动脉弓弥漫性受累的频率较高,但在预后方面无显著差异。