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Title: Effect of glucocorticoid treatment on computed tomography angiography detected large-vessel inflammation in giant-cell arteritis. A prospective, longitudinal study.
Author: Prieto González, Sergio
García Martínez, Ana
Tavera Bahillo, Itziar
Hernández Rodríguez, José
Gutiérrez Chacoff, José
Alba, Marco A.
Murgia, Giuseppe
Espígol Frigolé, Georgina
Sánchez, Marcelo
Arguis, Pedro
Cid Xutglà, M. Cinta
Keywords: Glucocorticoides
Arteritis de cèl·lules gegants
Efectes secundaris dels medicaments
Tomografia computada per emissió de fotó simple
Giant cell arteritis
Drug side effects
Single-photon emission computed tomography
Issue Date: Feb-2015
Publisher: Lippincott, Williams & Wilkins. Wolters Kluwer Health
Abstract: Computed tomography angiography (CTA) detects signs of large-vessel vasculitis (LVV) in about 67.5% of patients with giant-cell arteritis (GCA) at the time of diagnosis and early aortic dilatation in 15%. The outcome of CTA-findings of LVV upon glucocorticoid treatment has not been prospectively evaluated. The aim of our study was to prospectively assess glucocorticoid-induced changes in CTA findings of LVV in patients with GCA. Forty biopsy-proven GCA patients evaluated by CTA at diagnosis were prospectively followed and scheduled a new CTA approximately after 1 year of treatment. Vessel wall thickening, diameter, and contrast enhancement of the aorta and its tributaries were evaluated. Results were compared to those obtained at the time of diagnosis. CTA was repeated to 35 patients after a median follow-up of 13.5 months (IQ25-75% 12.4-15.8). Arterial wall thickening was still present in 17 patients (68% of the patients who initially had LVV). The number of affected segments and wall thickness at various aortic segments significantly decreased and no patients developed new lesions, new aortic dilation or increase in previous dilation. Contrast enhancement disappeared in 15 (93.75%) of 16 patients in whom this finding could be assessed. Signs of LVV improve with treatment. While contrast enhancement resolves in the majority of patients, vessel wall thickening persists in two thirds. However, the number of affected aortic segments as well as aortic wall thickness significantly decreases. Longer follow-up is necessary to determine the clinical significance of persisting wall thickening and its relationship with relapses or subsequent development of aortic dilatation or large-vessel stenoses.
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It is part of: Medicine, 2015, vol. 94, num. 5, p. e486
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ISSN: 0025-7974
Appears in Collections:Articles publicats en revistes (Medicina)

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