Differentiating Temporal arteritis from other diseases: Difference between revisions

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! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Joint stiffness]], [[Fatigue]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Joint stiffness]], [[Fatigue]]
|-
! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Granulomatosis with polyangiitis|Granulomatosis with polyangiitis (Wegener’s)]]<ref name="pmid27195187">{{cite journal| author=Kubaisi B, Abu Samra K, Foster CS| title=Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations. | journal=Intractable Rare Dis Res | year= 2016 | volume= 5 | issue= 2 | pages= 61-9 | pmid=27195187 | doi=10.5582/irdr.2016.01014 | pmc=4869584 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27195187  }}</ref>
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[C-ANCA|Anti-PR3 antibody (C-ANCA)]] (90%), [[P-ANCA|Anti-MPO antibody (P-ANCA)]] (10%)
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Normochromic anemia|Normochromic normocytic anemia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]], [[Hypoalbuminemia]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Consolidation (medicine)|Consolidation]], Patchy or diffuse [[Ground glass opacification on CT|ground-glass opacities]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Occlusion]] or [[stenosis]] of [[LAD]] and [[RCA]] in [[coronary angiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Single or multiple [[nodules]] and [[Mass|masses]] with [[cavitation]] in [[CXR]]
![[Parenchymal]] [[necrosis]], [[Granulomatous]] [[inflammation]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Histopathology|Histological confirmation]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Conjunctivitis]],
[[Episcleritis]],
[[Uveitis]],
[[Optic nerve]] vasculitis


==References==
==References==

Revision as of 01:58, 5 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Differentiating Temporal Arteritis from other Diseases

The following list is a differential diagnosis of disorders that temporal arteritis should be distinguished from.

Diseases Clinical manifestations Para-clinical findings Gold standard Additional findings
Symptoms Physical examination
Lab Findings Imaging Histopathology
Headache Fever Weight loss Arthralgia Claudication Bruit HTN Focal neurological disorder Biomarker CBC ESR Other CT scan Angiography Ultrasound/ Echocardiography Other
Large-Vessel Vasculitis Takayasu arteritis[1] + +/- + - + + +/- +/- MMP-3 and MMP-9 Leukocytosis, Anemia ↑ ↑CRP Aneurysmal dilatation of the aorta Blood vessel stenosis Circumferential thickening of the arterial wall (Macaroni sign) PET-scan, Cardiac CT Granulomatous inflammation of arteries Arteriography Coronary aneurysm
Giant cell arteritis[2] + - + +/- - - - +/- Pentraxin 3 (PTX3) Normal ↑ ↑CRP Stenosis, Occlusion, Dilatation Aneurysm - Mural inflammation in MRA Granulomatous inflammation of arteries Biopsy  Jaw pain and claudication
Polymyalgia rheumatica (PMR)[3] + - +/- + - - - - Plasma fibrinogen Normocytic, normochromic anemia ↑ CRP Periodontoid localization of calcification Vessel wall thickening, Increased mural contrast enhancement Subacromial or subdeltoid bursitis High F-FDG accumulation around the joints in FDG PET-CT Small angular fibers, Pyknotic nuclear clumps, or target-targetoid fibers - Joint stiffness, Fatigue
Granulomatosis with polyangiitis (Wegener’s)[4] + +/- +/- - - - - + Anti-PR3 antibody (C-ANCA) (90%), Anti-MPO antibody (P-ANCA) (10%) Leukocytosis, Normochromic normocytic anemia ↑ ↑Cr or BUN, Hypoalbuminemia Consolidation, Patchy or diffuse ground-glass opacities Occlusion or stenosis of LAD and RCA in coronary angiography - Single or multiple nodules and masses with cavitation in CXR Parenchymal necrosis, Granulomatous inflammation Histological confirmation Conjunctivitis,

Episcleritis,

Uveitis,

Optic nerve vasculitis

References

  1. ↑ Vaideeswar P, Deshpande JR (2013). "Pathology of Takayasu arteritis: A brief review". Ann Pediatr Cardiol. 6 (1): 52–8. doi:10.4103/0974-2069.107235. PMC 3634248. PMID 23626437.
  2. ↑ Calvo-Romero JM (2003). "Giant cell arteritis". Postgrad Med J. 79 (935): 511–5. PMC 1742823. PMID 13679546.
  3. ↑ Michet CJ, Matteson EL (2008). "Polymyalgia rheumatica". BMJ. 336 (7647): 765–9. doi:10.1136/bmj.39514.653588.80. PMC 2287267. PMID 18390527.
  4. ↑ Kubaisi B, Abu Samra K, Foster CS (2016). "Granulomatosis with polyangiitis (Wegener's disease): An updated review of ocular disease manifestations". Intractable Rare Dis Res. 5 (2): 61–9. doi:10.5582/irdr.2016.01014. PMC 4869584. PMID 27195187.


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