Rheumatology Unit, First Department of Propaedeutic Internal Medicine, School of Medicine, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Clinical Immunology-Rheumatology Unit, Fourth Department of Internal Medicine, School of Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Autoimmun Rev. 2022 May;21(5):103083. doi: 10.1016/j.autrev.2022.103083. Epub 2022 Mar 24.
Giant cell arteritis (GCA) is a large-vessel vasculitis that affects cranial and extra-cranial arteries. Extra-cranial GCA presents mainly with non-specific symptoms and the differential diagnosis is very broad, while the cranial form has more typical clinical picture and physicians have a lower threshold for diagnosis and treatment. Although temporal artery biopsy (TAB) has an established role, ultrasound (US) is being increasingly used as the first-line imaging modality in suspected GCA. Vasculitides (especially ANCA-associated), hematological disorders (mainly amyloidosis), neoplasms, infections, atherosclerosis and local disorders can affect the temporal arteries or might mimic the symptoms of cranial GCA and produce US and TAB findings that resemble those of temporal vasculitis. Given that prompt diagnosis is essential and proper treatment varies significantly among these diseases, in this review we aimed to collectively present disorders that can masquerade cranial GCA.
巨细胞动脉炎（GCA）是一种大血管血管炎，影响颅内外动脉。颅外 GCA 主要表现为非特异性症状，鉴别诊断非常广泛，而颅型则具有更典型的临床表现，医生对诊断和治疗的门槛较低。虽然颞动脉活检（TAB）具有既定的作用，但超声（US）越来越多地被用作疑似 GCA 的一线成像方式。血管炎（尤其是与 ANCA 相关的血管炎）、血液系统疾病（主要是淀粉样变性）、肿瘤、感染、动脉粥样硬化和局部疾病都可能影响颞动脉，或者可能模仿颅 GCA 的症状，并产生类似于颞血管炎的 US 和 TAB 发现。鉴于及时诊断至关重要，且这些疾病的治疗方法差异很大，因此在本次综述中，我们旨在集中介绍可能伪装成颅 GCA 的疾病。
