GCA is a chronic, idiopathic, granulomatous vasculitis of medium and large arteries. It comprises overlapping phenotypes including classic cranial arteritis and extra-cranial GCA, otherwise termed large-vessel GCA (LV-GCA). Vascular complications associated with LV-GCA may be due, in part, to delayed diagnosis, highlighting the importance of early identification and prompt initiation of effective therapy. Advancements in imaging techniques, including magnetic resonance angiography, CT angiography, PET and colour duplex ultrasonography, have led to improvements in the diagnosis of LV-GCA; however, the role imaging modalities play in the assessment of disease activity and long-term outcomes remains unclear. Glucocorticoids are the mainstay of therapy in LV-GCA, but their prolonged use is associated with multiple, sometimes serious, adverse effects. Recent data suggest that biologic therapies, such as tocilizumab, may be effective and safe steroid-sparing options for patients with GCA. However, data specifically evaluating the management of LV-GCA are limited."
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gifford7
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Thank you. It really is a nasty disease. I was diagnosed with GCA five years ago and despite very high markers CRP 189 I was lucky not too have suffered with too much damage. Now tapering to 6 mgms after several flares
Diagnosis of LV-GCA can be confirmed by imaging tests listed in Table 1.
I was diagnosed with GCA with vision loss in Nov 2017 biopsy confirmed. Several weeks later I had an MRA of the chest: "REPORT: Caliber of the thoracic aorta is within normal limits. Visualized portions of the great vessels and their origins are also normal in caliber limited visualization the pulmonary vasculature is unremarkable." I will need periodic repeats of the MRA.
My pred now tapered to 6.5mg after several flares.
However my sister was diagnosed with GCA with vision loss [& PMR] in 2010, and in 2016 with a heart murmer from aortitis requiring open heart surgery. So she has both cranial and large-vessel GCA.
Thank for posting this. It has been on before, but we do need reminding every so often, and new patients may not have seen it previously.
Many patients associate GCA with sight loss, and as we both know that is devastating enough, but there is much more to it than just the potential for sight problems.
Thanks, Gifford. I have GCA biopsy proven, 2012. Started off at 100mg pred and after three years and several flares, reduced to 1mg per day. Used the "slow" method, which I thought was best, less side effects. I have a dissecting right cartoid artery and still have migraine headaches, although much less severe. I also have meralgia paresthetica, which I am told might be exacerbated by swelling of the artery in the area of the inguineal tendon.
I still take one low dose aspirin per day. If I have an intractable headache, I take up to 8 mgs of medrol per day, 3 days and then taper down.
I also have PMR and now back spasms, new to two years ago. taking phys therapy, which at times, helps. very glad to have pred tapered down, have Cushingnoid syndrome, due to medication. glad to be off medrol.
Good post, well done. Thanks, Lynn -- Whittlesey Nyc
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