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GCA Patient (gca + patient)

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Medical Sciences100%

Selected Abstracts

Cancer preceding giant cell arteritis: A case,control study,

ARTHRITIS & RHEUMATISM, Issue 6 2010
Tanaz A. Kermani
Objective To study the association between previous cancer and giant cell arteritis (GCA). Methods Using the resources of the Rochester Epidemiology Project, we identified incident cases of GCA diagnosed between January 1, 1950 and December 31, 2004. Each GCA patient was matched for age, sex, and length of medical history to 2 subjects without GCA from the same population. Medical records were reviewed. Diagnosis of cancer was confirmed by histopathologic analysis. Results We identified 204 GCA cases and 407 controls. The GCA group included 163 women (80%) and 41 men (20%). Their mean ± SD age was 76.0 ± 8.2 years. The non-GCA group consisted of 325 women (80%) and 82 men (20%). Their mean ± SD age was 75.6 ± 8.4 years. At the index date, 45 GCA patients (22%) and 125 non-GCA patients (31%) had had a previous cancer. The odds ratio (OR) for previous cancer in cases compared with controls, adjusted for age, sex, and calendar year, was 0.63, and the 95% confidence interval (95% CI) was 0.42,0.94 (P = 0.022). The mean age at diagnosis of the first cancer before the index date was similar in the cases (67.5 ± 11.9 years) and the controls (64.9 ± 13.2 years) (P = 0.32). The mean ± SD duration from the first cancer to the index date was 9.8 ± 9.9 years in the cases and 11.7 ± 10.8 years in the controls (P = 0.31). Cancer types were similar in both groups, but fewer gynecologic malignancies were noted in GCA patients (OR 0.39 [95% CI 0.13,1.15], P = 0.09). Colon cancer also appeared less commonly in the cases compared with the controls (OR 0.22 [95% CI 0.03,1.74], P = 0.15). Conclusion The findings of this population-based case,control study indicate that GCA patients had significantly fewer malignancies prior to the index date as compared with controls. [source]

4343: What next when the biopsy is negative in suspected giant cell arteritis (GCA)?

ACTA OPHTHALMOLOGICA, Issue 2010
A BOSCHI
Purpose To present and discuss the approach of GCA when temporal artery biopsy (TAB) is negative. Recommendations for reducing the rate of negative TAB Methods GCA is the commonest vasculitis. Visual loss occurs in up to one-fifth of patients, which may be preventable by prompt recognition and treatment. Features predictive of ischaemic neuro-ophthalmic complications are: jaw claudication, diplopia, and temporal artery abnormalities on physical examination. These manifestations and particularly blindness and jaw claudication seems to be more commonly associated with positive TAB. Results Despite visual symptoms TAB may result negative. Rate of negative TAB varies from 7% to 40% in pat suspected of GCA. TAB should be done 2 to 6 weeks after commencement of treatment, and at least 1 cm. Contralateral biopsy is controversies, usually it increases the rate of GCA diagnosis of only 5%. Conclusion If TAB is still however negative, but clinical suspicion high or Ultra-Sound suggests GCA or complications typical of GCA, like anterior ischemic optic neuropathy, patient should be treat as biopsy-positive GCA patient. If the clinical suspicion is low, features considered atypical or alternative explanations available, rapid glucocorticoid therapy should be tapered. [source]

Cancer preceding giant cell arteritis: A case,control study,

ARTHRITIS & RHEUMATISM, Issue 6 2010
Tanaz A. Kermani
Objective To study the association between previous cancer and giant cell arteritis (GCA). Methods Using the resources of the Rochester Epidemiology Project, we identified incident cases of GCA diagnosed between January 1, 1950 and December 31, 2004. Each GCA patient was matched for age, sex, and length of medical history to 2 subjects without GCA from the same population. Medical records were reviewed. Diagnosis of cancer was confirmed by histopathologic analysis. Results We identified 204 GCA cases and 407 controls. The GCA group included 163 women (80%) and 41 men (20%). Their mean ± SD age was 76.0 ± 8.2 years. The non-GCA group consisted of 325 women (80%) and 82 men (20%). Their mean ± SD age was 75.6 ± 8.4 years. At the index date, 45 GCA patients (22%) and 125 non-GCA patients (31%) had had a previous cancer. The odds ratio (OR) for previous cancer in cases compared with controls, adjusted for age, sex, and calendar year, was 0.63, and the 95% confidence interval (95% CI) was 0.42,0.94 (P = 0.022). The mean age at diagnosis of the first cancer before the index date was similar in the cases (67.5 ± 11.9 years) and the controls (64.9 ± 13.2 years) (P = 0.32). The mean ± SD duration from the first cancer to the index date was 9.8 ± 9.9 years in the cases and 11.7 ± 10.8 years in the controls (P = 0.31). Cancer types were similar in both groups, but fewer gynecologic malignancies were noted in GCA patients (OR 0.39 [95% CI 0.13,1.15], P = 0.09). Colon cancer also appeared less commonly in the cases compared with the controls (OR 0.22 [95% CI 0.03,1.74], P = 0.15). Conclusion The findings of this population-based case,control study indicate that GCA patients had significantly fewer malignancies prior to the index date as compared with controls. [source]

Endothelial nitric oxide synthase gene polymorphisms in giant cell arteritis

ARTHRITIS & RHEUMATISM, Issue 11 2003
Carlo Salvarani
Objective To examine potential associations of the Glu/Asp298 polymorphism in exon 7 and the 4a/b polymorphism in intron 4 of the endothelial nitric oxide synthase (eNOS) gene with susceptibility to and clinical expression of giant cell arteritis (GCA), particularly in patients with versus those without ischemic complications. Methods Ninety-one consecutive patients with biopsy-proven GCA, who were residents of Reggio Emilia, Italy, and 133 population-based controls from the same geographic area were genotyped by polymerase chain reaction and allele-specific oligonucleotide techniques for eNOS polymorphisms in exon 7 and intron 4. The patients were separated into 2 subgroups according to the presence or absence of ischemic complications (visual loss and/or jaw claudication and/or aortic arch syndrome). Results The distribution of the Glu/Asp298 genotype differed significantly between GCA patients and controls (corrected P [Pcorr] = 0.003). Carriers of the Asp298 allele (Asp/Asp or Glu/Asp) were significantly more frequent among the GCA patients than among the controls (Pcorr = 0.0002, odds ratio 3.3, 95% confidence interval 1.7,6.3). The distribution of the 4a/b genotype was similar in GCA patients and controls. No significant associations were found when GCA patients with and without ischemic complications were compared. Conclusion Our findings show that the Glu/Asp298 polymorphism of the eNOS gene is associated with GCA susceptibility. [source]