Abstract
Polymyalgia rheumatica (PMR) may be associated with vascular complications for a number of reasons: 1/the inflammatory nature of the disease itself, 2/strong association with giant cell arteritis (GCA – which has a direct inflammatory effect on arteries and may result in either stenosis or aneurysm within affected segments), 3/side effect of the corticosteroid treatment (including arterial hypertension, dyslipidemia and/or diabetes mellitus). GCA is a systemic granulomatous vasculitis, typically affecting branches of carotid artery mainly temporal artery; however, any other medium or large artery can be affected. This fact complicates diagnosis of the disease. Diagnostic possibilities of GCA are discussed in this chapter.
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Hancock AT, Mallen CD, Belcher J, Hider SL. Association between polymyalgia rheumatic and vascular diseases: a systemic review. Arthritis Care Res. 2012;64(9):1301–5.
Kremers HM, Reinalda MS, Crowson CS, Davis JM, Hunder GG, Gabriel SE. Glucocorticoids and cardiovascular and cerebrovascular events in polymyalgia rheumatic. Arthritis Rheum. 2007;57:279–86.
Schaufelberger C, Bengtsson BA, Andersson R. Epidemiology and mortality in 220 patients with polymyalgia rheumatic. Br J Rheumatol. 1995;34:261–4.
Uddhammar A, Eriksson A, Nystrom L, Stenling R, Rantapaa-Dahlqvist S. Increased mortality due to cardiovascular disease in patients with giant cell arteritis in northern Sweden. J Rheumatol. 2002;29:737–42.
Warrington KJ, Jarpa EP, Crowson CS, Cooper LT, Hunder GG, Matteson EL, et al. Increased risk of peripheral arterial disease in polymyalgia rheumatic: a population based cohort study. Arthritis Res Ther. 2009;11:50.
Murphy EA, Capell H. Aortitis and large vessel vasculitides. In: Tooke JE, Lowe GDO, editors. A textbook of vascular medicine. London: Arnold; 1996. p. 287–94.
Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. Lancet. 2008;372:234–45.
Rovenský J, Tauchmannová H, Štvrtinová V, Štvrtina S, Duda J. Polymyalgia rheumatica a obrovskobunková arteritída, príspevok ku klinicko-laboratórnej syndromológii a terapii. Čes Revmatol. 2006;14(3):135–43.
Bengtsson BA. Giant cell arteritis. In: Ansell BM, Bacon PA, Lie JT, Yazici H, editors. The vasculitides. Science and practice. London: Chapman and Hall Medical; 1996. p. 171–80.
Lie JT. Coronary vasculitis. A review in the current scheme of classification of vasculitis. Arch Pathol Lab Med. 1987;111(3):224–33.
Weyand CM, Goronzy JJ. Pathogenetic principles in giant cell arteritis. Int J Cardiol. 2000;75(Suppl 1):S9–15.
Jennette IC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994;17(2):187–92.
Lie JT, Failoni DD, Davis DC. Temporal arteritis with giant cell aortitis, coronary arteritis, and myocardial infarction. Arch Pathol Lab Med. 1986;110(9):857–60.
Štvrtina S, Rovenský J, Galbavý Š. Aneuryzma aorty ako príčina smrti pri obrovskobunkovej arteritíde. Rheumatologia. 2003;17(3):213–20.
Lie JT. Aortic and extracranial large vessel giant eel arteritis: a review of 72 cases with histopathologic documentation. Semin Arthritis Rheum. 1995;24(6):422–31.
Borchers AT, Gershwin ME. Giant cell arteritis: a review of classification, pathophysiology, geoepidemiology and treatment. Autoimmun Rev. 2012;11:A544–54.
Pipinos II, Hopp R, Edwards WD, Radio SJ. Giant cell temporal arteritis in a 17-year-old male. J Vasc Surg. 2006;43(5):1053–5.
Rovenský J, Tauchmannová H, Štvrtinová V, Štvrtina S. Príspevok k problematike juvenilnej temporálnej arteritídy. Rheumatologia. 2005;19(4):153–5.
Bengtsson BA, Malmvall BE. The epidemiology of giant cell arteritis including temporal arteritis and polymyalgia rheumatica. Arthritis Rheum. 1981;24:899–904.
Huston KA, Hunder GG, Lie JT, et al. Temporal arteritis: a 25-year epidemiologic, clinical and pathologic study. Ann Intern Med. 1978;88(2):162–7.
Smeeth L, Cook C, Hall AJ. Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990 to 2001. Ann Rheum Dis. 2006;65(8):1093–8.
Kermani TA, Schafer VS, Crowson CS, Hunder GG, Gabriel SE, Matteson EL, et al. Increase in age at onset of giant cell arteritis: a population-based study. Ann Rheum Dis. 2010;69:780–1.
Interpolated demographic indicators by major area, region and country, annually for 1950–2100. Medium Fertility variant, 2010–2100. http://esa.un.org/wpp/Excel-Data/Interpolated.htm. Accessed 4 Jan 2014.
De Smit E, Palmer AJ, Hewitt AW. Projected worldwide disease burden from giant cell arteritis by 2050. J Rheumatol. 2015;42:119–125. doi:10.3899/jrheum.140318 [PubMed].
Rovenský J, Štvrtinová V, Tauchmannová H, Duda J. Polymyalgia rheumatica and giant cell arteritis—importance of factors contributing to severity of disease. Rheuma 21st, Archived Reports. www.rheuma21st.com/archives/cutting
Lee SJ, Kavanaugh Α. Autoimmunity, vasculitis and autoantibodies. J Allergy Clin Immunol. 2006;117(2):S445–50.
Hellmann DB. Immunopathogenesis, diagnosis, and treatment of giant cell arteritis, temporal arteritis, polymyalgia rheumatica, and Takayasu’s arteritis. Curr Opin Rheumatol. 1993;5:25–32.
Imrich R, Bošák V, Rovenský J. Polymyalgia rheumatic a temporálna arteritída: vzťah hormónov k patogenéze. Rheumatologia. 2003;17(l):69–77.
Olsson Α, Elling P, Elling H. Synchronous variations of the incidence of arteritis temporalis and polymyalgia rheumatic in different regions of Denmark; association with epidemics of Mycoplasma pneumoniae infection. Clin Rheumatol. 1994;13(2):384.
Perfetto F, Moggi-Pignone M, Becucci A, et al. Seasonal pattern in the onset of polymyalgia rheumatica. Ann Rheum Dis. 2005;64:1662–3.
Nordborg C, Nordborg E, Petursdottir V. The pathogenesis of giant cell arteritis: morphological aspects. Clin Exp Rheumatol. 2000;18(4 Suppl 20):S18–21.
Nordborg C, Nordborg E, Petursdottir V, Fyhr IM. Calcification of the internal elastic membrane in temporal arteries:its relation to age and gender. Clin Exp Rheumatol. 2001;19(5):565–8.
Weyand CM, Goronzy JJ. Pathogenetic mechanisms in giant cell arteritis. Cleve Clin J Med. 2002;69(Suppl 2):SII28–32.
Kaiser M, Younge B, Bjornsson J, et al. Formation of new vasa vasorum in vasculitis. Production of angiogenic cytokines by multinucleated giant cells. Am J Pathol. 1999;155(3):765–74.
Lie JT. Illustrated histopathologic classification criteria for selected vasculitis syndromes. Arthritis Rheum. 1990;33(8):1074–87.
Liu G, Shupak R, Chiu BK. Aortic dissection in giant cell arteritis. Semin Arthritis Rheum. 1995;25(3):160–71.
Evans JM, O’Fallon WM, Hunder GG. Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population-based study. Ann Intern Med. 1995;122(7):502–7.
Karger B, Fechner G. Sudden death due to giant cell coronary arteritis. Int J Leg Med. 2006;120(6):377–9.
Martin JF, Kittas C, Triger DR. Giant cell arteritis of coronary arteries causing myocardial infarction. Br Heart J. 1980;43(4):487–9.
Säve-Soderbergh J, Malmvall BE, Andersson R, Bengtsson BA. Giant cell arteritis as a cause of death. JAMA. 1986;255(4):493–6.
Polak P, Pokorný V, Štvrtina S, et al. Temporal arteritis presenting with paresis of the oculomotor nerve and polymyalgia rheumatica, despite a low erythrocyte sedimentation rate. J Clin Rheumatol. 2005;11(4):242–4.
Dupuy R, Mercié P, Neau D, et al. Giant cell arteritis involving the lower limbs. Rev Rheum Engl Ed. 1997;64:500–3.
Garcia Vázques JM, Carreira JM, Seoane C, et al. Superior and inferior limb ischemia in giant cell arteritis: angiography follow up. Clin Rheumatol. 1999;18:61–5.
Le Hello C, Lévesque H, Leanton M, et al. Lower limb giant cell arteritis and temporal arteritis: follow up of 8 cases. J Rheumatol. 2001;28(6):1407–11.
Tato F, Hoffmann U. Clinical presentation and vascular imaging in giant cell arteritis of the femoropopliteal and tibioperoneal arteries. Analysis of four cases. J Vasc Surg. 2006;44(1):176–82.
Ungprasert P, Thongprayoon C, Kittanamongkolchal W, Srivali N, Cheungpasitporn W. Peripheral arterial disease in patients with giant cell arteritis: a meta-analysis. Int J Rheum Dis. 2016;19(18):819–25. doi:10.1111/1756-185X.12631. Epub 2015 Jul 28. [Epub ahead of print].
Aschwaden M, Kesten F, Stern M, et al. Vascular involvement in patients with giant cell arteritis determined by duplex sonography of 2x11 arterial regions. Ann Rheum Dis. 2010;69:1356–9.
Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of the giant cell arteritis. Arthritis Rheum. 1990;33(8):1122–8.
Smetana GW, Shmerling RH. Does this patient have temporal arteritis? JAMA. 2002;287:92–101.
Schmidt WA, Gromica-Ihle E. Incidence of temporal arteritis in patients with polymyalgia rheumatica: a prospective study using colour doppler ultrasound of the temporal arteries. Rheumatology (Oxford). 2002;41:46–52.
Meisner RJ, Labropoulos N, Gasparis AP, Tassiopoulos AK. How to diagnose giant cell arteritis. Int Angiol. 2011;30:58–63.
Kolossváry E, Kollár Α, Pintér Η, et al. Bilateral axillobrachial and external carotid artery manifestation of giant cell arteritis: important role of color duplex ultrasonography in the diagnosis. Int Angiol. 2005;24(2):202–5.
Herve F, Choussy V, Janvresse A, et al. Aortic involvement in giant cell arteritis. A prospective follow-up of 11 patients using computed tomography. Rev Med Interne. 2006;27(3):196–202.
Joyce JW. Arteritis. In: Eastcott HHG, editor. Arterial surgery. Madrid: Churchill Livingstone; 1992. p. 211–22.
Štvrtinová V, Rauová L, Tuchyňová Α, Rovenský J. Vasculitis of the coronary arteries and atherosclerosis: random coincidence or causative relationship? In: Shoenfeld Y, Harats D, Wick G, editors. Atherosclerosis and autoimmunity. Amsterdam: Elsevier; 2001. p. 315–27.
Nesher G, Sonnenblick M. Steroid-sparing medications in temporal arteritis—report of three cases and review of 174 reported patients. Clin Rheumatol. 1994;13(2):289–92.
Tuchyňová Α, Rovenský J, Mičeková D. Polymyalgia rheumatica a temporálna arteritída—klinický obraz a liečba. Rheumatologia. 1998;12(3):117–22.
Gonzales-Juanatey C, Llorca J, Garcia-Porrua C, et al. Steroid therapy improves endothelial function in patients with biopsy, proven giant cell arteritis. J Rheumatol. 2006;33(1):74–8.
Both M, Aries PM, Muller-Hulsbeck S, et al. Balloon angioplasty of upper extremity in patients with extracranial giant cell arteritis. Ann Rheum Dis. 2006;65(9):1124–30.
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Štvrtinová, V., Čelovská, D., Štvrtina, S., Rovenský, J. (2017). Polymyalgia Rheumatica, Giant Cell Arteritis, and Vascular Complications. In: Rovenský, J., Leeb, B., Štvrtinová, V., Imrich, R. (eds) Polymyalgia Rheumatica and Giant Cell Arteritis. Springer, Cham. https://doi.org/10.1007/978-3-319-52222-7_3
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