Large Vessel Vasculitides: Giant Cell Arteritis and Takayasu Arteritis - Similarities and Differences

Abstract

Large Vessel Vasculitides: Giant Cell Arteritis and Takayasu Arteritis - Similarities and Differences Abstract. According to the Chapel Hill Consensus Conference Nomenclature of 2012, giant cell arteritis (GCA) and Takayasu arteritis (TAK) belong to the idiopathic large vessel vasculitides. While GCA is a typical disease of the elderly, TAK begins in adolescence and young adulthood, sometimes even in childhood. In both diseases, immune-mediated granulomatous vascular wall inflammation of the aorta and its major branches leads to the formation of stenoses, occlusions, and aneurysms. The reduced blood flow to downstream organs causes the characteristic symptoms such as visual disturbance, ischemic muscle pain, and dysesthesias. Typically, a pronounced systemic reaction with constitutional symptoms such as temperature elevation, fatigue, and weight loss is present. If GCA or TAK is suspected, vasculitis should always be confirmed by imaging (ultrasound, MRI, or PET-CT) and/or histology. In addition to induction therapy with glucocorticoids, steroid-sparing immunosuppressants such as tocilizumab and infliximab have become increasingly important in recent years, prompting the EULAR to update its recommendations for the management of large-vessel vasculitis in 2018.