The Experts below are selected from a list of 138 Experts worldwide ranked by ideXlab platform
Carlo Salvarani - One of the best experts on this subject based on the ideXlab platform.
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Large-vessel involvement in giant cell arteritis and polymyalgia rheumatica.
Clinical and experimental rheumatology, 2014Co-Authors: Francesco Muratore, Giulia Pazzola, Nicolò Pipitone, Luigi Boiardi, Carlo SalvaraniAbstract:Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are closely related disorders that affect people of middle age and older, and frequently occur together. With the widespread use of newer vascular imaging modalities, large-vessel involvement (LVI) has increasingly been recognised in patients with GCA and less often in those with PMR. LVI in GCA can result in complications such as Aortic aneurysm and dissection, Aortic Arch Syndrome, and limb arteries stenosis, while vascular complications in PMR are exceedingly rare. It is still controversial which patients should be investigated for LVI, and how LVI should be diagnosed, monitored and managed. In this review, we will try to address six important issues regarding LVI in GCA and PMR.
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polymyalgia rheumatica and giant cell arteritis
The Lancet, 2008Co-Authors: Carlo Salvarani, Fabrizio Cantini, Gene G HunderAbstract:Polymyalgia rheumatica and giant-cell arteritis are closely related disorders that affect people of middle age and older. They frequently occur together. Both are Syndromes of unknown cause, but genetic and environmental factors might have a role in their pathogenesis. The symptoms of polymyalgia rheumatica seem to be related to synovitis of proximal joints and extra-articular synovial structures. Giant-cell arteritis primarily affects the aorta and its extracranial branches. The clinical findings in giant-cell arteritis are broad, but commonly include visual loss, headache, scalp tenderness, jaw claudication, cerebrovascular accidents, Aortic Arch Syndrome, thoracic aorta aneurysm, and dissection. Glucocorticosteroids are the cornerstone of treatment of both polymyalgia rheumatica and giant-cell arteritis. Some patients have a chronic course and might need glucocorticosteroids for several years. Adverse events of glucocorticosteroids affect more than 50% of patients. Trials of steroid-sparing drugs have yielded conflicting results. A greater understanding of the molecular mechanisms involved in the pathogenesis should provide new targets for therapy.
Jay H. Anderson - One of the best experts on this subject based on the ideXlab platform.
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Clinical application of captopril renal scintigraphy in Takayasu's arteritis.
Clinical nuclear medicine, 1993Co-Authors: Antonio G. Balingit, Jay H. AndersonAbstract:Takayasu's disease (pulseless disease) is an uncommon chronic Inflammatory disease primarily affecting the medium and large arteries, with a strong predilection for the Aortic Arch and its branches; hence, it sometimes is referred to as Aortic Arch Syndrome. The etiology is unknown, although a systemic immunologic process seems most likely. About half the reported cases also revealed involvement of the pulmonary and renal arterles. The involvement is more marked in the origin of the vessel than distally. Although it is more common among Orientals, its distribution is worldwide, without racial boundary. A case is presented in which captopril renal scintigraphy and digital subtraction angiography were used to show renal artery stenosis as the cause of the patient's hypertension
Gene G Hunder - One of the best experts on this subject based on the ideXlab platform.
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polymyalgia rheumatica and giant cell arteritis
The Lancet, 2008Co-Authors: Carlo Salvarani, Fabrizio Cantini, Gene G HunderAbstract:Polymyalgia rheumatica and giant-cell arteritis are closely related disorders that affect people of middle age and older. They frequently occur together. Both are Syndromes of unknown cause, but genetic and environmental factors might have a role in their pathogenesis. The symptoms of polymyalgia rheumatica seem to be related to synovitis of proximal joints and extra-articular synovial structures. Giant-cell arteritis primarily affects the aorta and its extracranial branches. The clinical findings in giant-cell arteritis are broad, but commonly include visual loss, headache, scalp tenderness, jaw claudication, cerebrovascular accidents, Aortic Arch Syndrome, thoracic aorta aneurysm, and dissection. Glucocorticosteroids are the cornerstone of treatment of both polymyalgia rheumatica and giant-cell arteritis. Some patients have a chronic course and might need glucocorticosteroids for several years. Adverse events of glucocorticosteroids affect more than 50% of patients. Trials of steroid-sparing drugs have yielded conflicting results. A greater understanding of the molecular mechanisms involved in the pathogenesis should provide new targets for therapy.
Yildiz Babadag - One of the best experts on this subject based on the ideXlab platform.
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The anesthetic manegement of a case with Aortic Arch Syndrome-Takayasu's Arteriti's
Abant Medical Journal, 2014Co-Authors: Kevser Peker, Recai Dagli, Yildiz BabadagAbstract:Takayasu Arteriti aorta ve ana dallari gibi genis damar duvarlarinda yaygin inflamasyonla karekterize nadir gorulen bir hastaliktir. Nabizsizlik hastaligi olarak ta bilinir. Kadinlarda erkeklerden daha fazla ve genellikle genc yaslarda gozlenir (1). Anjiografide daralan buyuk damar yapilarinin gozlenmesiyle tani konur. Bu daralma stenoz olarak adlandirilir (2). Kan akiminin azalmasi, doku ve organlara ihtiyaci olan oksijenin tasinamamasina neden olur. Boylece tum yasami etkileyen problemler ortaya cikar.
M. Bähre - One of the best experts on this subject based on the ideXlab platform.
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MRI and FDG-PET in the assessment of inflammatory Aortic Arch Syndrome in complicated courses of giant cell arteritis
Annals of the rheumatic diseases, 2008Co-Authors: Marcus Both, Wolfgang L. Gross, Martin Heller, M. Reuter, K Ahmadi-simab, O. Dourvos, E. Fritzer, Sebastian Ullrich, M. BähreAbstract:Objectives: To evaluate the use of MRI and FDG-PET for the diagnosis and measurement of disease activity of inflammatory Aortic Arch Syndrome in patients with complicated giant cell arteritis. Methods: MRI and FDG-PET were performed for 25 patients with giant cell arteritis who presented with a complicated disease course despite immunosuppressive therapy. Disease activity of the thoracic aorta and the supra-Aortic arteries as assessed by both modalities was compared with serological (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) and clinical findings (Birmingham vasculitis activity score (BVAS.2)). Additionally, the usefulness of MRI for assessment of vessel wall thickening, aneurysms and stenoses was evaluated. Results: In 17/25 patients, MRI disclosed structural vessel lesions suspicious for vasculitis. Active disease was detected by MRI, thoracic PET, and whole body PET in 22, 14 and 20 patients, respectively. While serological and clinical findings correlated significantly with each other, there was no concordance with MRI and only low, non-significant correlation of PET with CRP ( r s = −0.158, 0.136), ESR ( r s = −0.232, 0.320) and BVAS.2 ( r s = −0.064, 0.221) for disease activity. Conclusions: MRI and PET are unreliable for assessing large-vessel inflammation in patients with giant cell arteritis and pre-existing immunosuppressive therapy. MRI is valuable for its ability to detect morphological vessel lesions, such as aneurysms and stenoses.