Giant cell arteritis
Giant cell arteritis
复制标题
巨细胞动脉炎
DOI：
10.1016/j.berh.2016.05.001
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发表时间：
2016-02-01
影响因子：
5.2
通讯作者：
Hill, Catherine
中科院分区：
文献类型：
--
作者：
Ninan, Jem;Lester, Susan;Hill, Catherine
巨细胞动脉炎（GCA）是老年人最常见的血管炎。由于美国流变学协会（ARA）分类标准的局限性和GCA活检阴性患者的显著比例，诊断有时具有挑战性。我们讨论了先进的成像技术，包括正电子发射断层扫描（PET）扫描，在建立诊断和改进的组织病理学技术，以提高颞动脉活检的敏感性的作用。GCA的发病机制的理解，特别是细胞因子途径的作用，如白细胞介素，IL-6-IL-17轴，和IL-12-干扰素-γ轴和它们的新的治疗方法的含义有显着的进步。我们强调糖皮质激素仍然是GCA的主要治疗方法，但认识到类固醇诱导的副作用的风险。已经研究了一些药物疗法，使糖皮质激素剂量减少和防止复发。早期诊断和快速通道途径，通过鼓励坚持循证实践，改善了结果。(C)2016爱思唯尔有限公司版权所有。
Giant cell arteritis (GCA) is the most common vasculitis of the elderly. The diagnosis can be challenging at times because of the limitation of the American Rheumatology Association (ARA) classification criteria and the significant proportion of biopsy-negative patients with GCA. We discuss the role of advanced imaging techniques, including positron emission tomography (PET) scanning, in establishing diagnosis and improved histopathology techniques to improve the sensitivity of temporal artery biopsy. There have been significant advances in the understanding of the pathogenesis of GCA, particularly the role of cytokine pathways such as the interleukins, IL-6-IL-17 axis, and the IL-12-interferon-gamma axis and their implication for new therapies. We highlight that glucocorticoids remain the primary treatment for GCA, but recognize the risk of steroid-induced side effects. A number of pharmacotherapies to enable glucocorticoid dose reduction and prevent relapse have been studied.Early diagnosis and fast-track pathways have improved outcomes by encouraging adherence to evidence-based practice. (C) 2016 Elsevier Ltd. All rights reserved.