Rheumatology Department, Santa Chiara Regional Hospital and Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Largo Madaglie D'Oro 9, 38121, Trento, Italy.
Thoracic Disease Research Unit, Pulmonary and Critical Care, Mayo Clinic, Rochester, MN, USA.
Curr Rheumatol Rep. 2020 Nov 7;22(12):88. doi: 10.1007/s11926-020-00965-w.
To provide an overview of mimickers of large vessel vasculitis (LVV), by the main presenting manifestation, i.e., systemic, vascular, and cranial manifestations.
The main differential diagnoses in patients with giant cell arteritis (GCA) and Takayasu arteritis (TAK) presenting with systemic manifestations (i.e., fever, anorexia, weight loss, night sweats, arthralgia/myalgia, and/or increased inflammatory indexes) are neoplastic, infectious, or other inflammatory conditions. In patients with vascular manifestations (such as peripheral ischemia, vascular stenoses, or aneurysms), atherosclerosis and non-inflammatory vascular diseases should be excluded. In those presenting with predominant cranial symptoms (i.e., temporal headache, jaw claudication, scalp tenderness, transient or permanent vision loss), other causes of headache, cerebrovascular accidents, optic neuropathy, and neuromuscular syndromes need to be considered. The diagnosis of LVV maybe challenging, especially when patients present with atypical or incomplete clinical forms. In these cases, a multidisciplinary approach is strongly recommended.
根据主要表现(全身性、血管性和颅性表现),概述大血管血管炎(LVV)的各种表现形式。
巨细胞动脉炎(GCA)和 Takayasu 动脉炎(TAK)患者出现全身表现(如发热、厌食、体重减轻、盗汗、关节痛/肌痛和/或炎症指标升高)时,主要的鉴别诊断包括肿瘤、感染或其他炎症性疾病。出现血管表现(如周围缺血、血管狭窄或动脉瘤)时,应排除动脉粥样硬化和非炎症性血管疾病。主要表现为颅性症状(即颞部头痛、下颌跛行、头皮触痛、一过性或永久性视力丧失)的患者,需要考虑其他头痛原因、脑血管意外、视神经病变和神经肌肉综合征。LVV 的诊断可能具有挑战性,尤其是当患者出现不典型或不完整的临床形式时。在这些情况下,强烈建议采用多学科方法。