Differentiating Temporal arteritis from other diseases: Difference between revisions

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Revision as of 15:04, 9 April 2018

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [2]

Overview

Differentiating Temporal Arteritis from other Diseases

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

Abbreviations: ABG= Arterial blood gas, ANA= Antinuclear antibody, ANP= Atrial natriuretic peptide, ASO= Antistreptolysin O antibody, BNP= Brain natriuretic peptide, CBC= Complete blood count, COPD= Chronic obstructive pulmonary disease, CRP= C-reactive protein, CT= Computed tomography, CXR= Chest X-ray, DVT= Deep vein thrombosis, ESR= Erythrocyte sedimentation rate, HRCT= High Resolution CT, IgE= Immunoglobulin E, LDH= Lactate dehydrogenase, PCWP= Pulmonary capillary wedge pressure, PCR= Polymerase chain reaction, PFT= Pulmonary function test.

			Symptoms					Physical examination			Lab Findings				Imaging				Histopathology
Diseases			Clinical manifestations								Para-clinical findings									Gold standard	Additional findings
			Symptoms					Physical examination			Para-clinical findings
			Headache	Fever	Weight loss	Arthralgia	Claudication	Bruit	HTN	Focal neurological disorder	Biomarker	CBC	ESR	Other	CT scan	Angiography	Ultrasound/ Echocardiography	Other	Histopathology
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
	Neurological disease	Cerebral aneurysm^[3]	+	-	-	-	-	-	+/-	+	-	Normal	Normal	-	Well-defined round, slightly hyperattenuating lesion	Bulging out of the main lumen	-	Heterogeneous signal intensity in MRA	Layers of smooth muscle cells, Intact endothelium	Digital subtraction angiography (DSA)	Nausea, Vomiting
		Neurofibromatosis type 1^[4]	+/-	-	+/-	-	-	-	+	+	NF1 mutated gene	Normal	Normal	Neurofibromin gene	Bone abnormalities	Optical coherence tomography angiography (OCTA)	-	Optic nerve gliomas in MRI	Elongated spindle-shaped cells in neurofibromas	NIH diagnostic criteria	Cafe au Lait spot
		Neurofibromatosis type 2^[5]	+/-	-	+/-	-	+/-	-	-	+	NF2 mutated gene	Normal	Normal	Schwannomin	Meningioma, Schwannoma, Ependymoma	Fluorescein angiography showed retinal hamartoma	Localized schwannomas in nerve ultrasound	Schwannoma in MRI	Encapsulated biphasic nerve sheath tumor	NIH diagnostic criteria	Hearing loss, Vision loss
	Systemic disease	Fibromuscular dysplasia^[6]	+	-	+/-	+	+	+	+	+/-	Transforming growth factor β (TGF-β)	Normal	↑	↑ Cr or BUN	Alternating stenosis and dilatations in CT angiography	Stenosis in the renal arteries	Luminal narrowing alternating with dilatation (Beads sign)	Focal concentric, long-segment tubular stenosis or outpouching in MRA	Fibrodysplastic changes, Collagen deposition	Digital subtraction angiography (DSA)	Spontaneous coronary artery dissection (SCAD)
		Ehlers-Danlos syndrome^[7]	-	-	-	+	+/-	+/-	-	+/-	TGF-β	Normal	Normal	Cultured skin fibroblasts	Multiple vascular segments with aneurysms and dissections	Dissection of the posterolateral branch of the left circumflex coronary artery (LCx)	Visceral arteries abnormality	Vascular abnormalities in MRA	Thin and rare collagen bundles in the dermis	History and physical examination	Bleeding, Bruisability, Heart murmur
		Polymyalgia rheumatica (PMR)^[8]	+	-	+/-	+	-	-	-	-	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
		Amyloidosis^[9]	+/-	-	-	+/-	+/-	-	+	+	Immunoglobulin light chain (Amyloid)	Anemia	Normal	↑ Cr or BUN, ↑ ALT or AST	Diffusely hypoattenuating and enlarged liver	Amyloid deposition in the media and adventitia of small arteries	Solid organs increased echogenicity	Tc-DPD for cardiac amyloid deposits	Extracellular deposition of fibrillar proteins	Biopsy	Cardiomegaly, Dyspnea

References

↑ 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.
↑ Calvo-Romero JM (2003). "Giant cell arteritis". Postgrad Med J. 79 (935): 511–5. PMC 1742823. PMID 13679546.
↑ Stafa A, Leonardi M (2008). "Role of neuroradiology in evaluating cerebral aneurysms". Interv Neuroradiol. 14 Suppl 1: 23–37. doi:10.1177/15910199080140S106. PMC 3328052. PMID 20557771.
↑ Cassiman C, Casteels I, Stalmans P, Legius E, Jacob J (2017). "Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1". Case Rep Ophthalmol. 8 (1): 214–220. doi:10.1159/000469702. PMC 5422752. PMID 28512424.
↑ Evans, D G. R (2000). "Neurofibromatosis type 2". Journal of Medical Genetics. 37 (12): 897–904. doi:10.1136/jmg.37.12.897. ISSN 1468-6244.
↑ Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007). "Fibromuscular dysplasia". Orphanet J Rare Dis. 2: 28. doi:10.1186/1750-1172-2-28. PMC 1899482. PMID 17555581.
↑ Gazit Y, Jacob G, Grahame R (2016). "Ehlers-Danlos Syndrome-Hypermobility Type: A Much Neglected Multisystemic Disorder". Rambam Maimonides Med J. 7 (4). doi:10.5041/RMMJ.10261. PMC 5101008. PMID 27824552.
↑ Michet CJ, Matteson EL (2008). "Polymyalgia rheumatica". BMJ. 336 (7647): 765–9. doi:10.1136/bmj.39514.653588.80. PMC 2287267. PMID 18390527.
↑ Baker KR, Rice L (2012). "The amyloidoses: clinical features, diagnosis and treatment". Methodist Debakey Cardiovasc J. 8 (3): 3–7. PMC 3487569. PMID 23227278.

Template:WikiDoc Sources

[pmid23626437-1] 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.

[pmid13679546-2] Calvo-Romero JM (2003). "Giant cell arteritis". Postgrad Med J. 79 (935): 511–5. PMC 1742823. PMID 13679546.

[pmid20557771-3] Stafa A, Leonardi M (2008). "Role of neuroradiology in evaluating cerebral aneurysms". Interv Neuroradiol. 14 Suppl 1: 23–37. doi:10.1177/15910199080140S106. PMC 3328052. PMID 20557771.

[pmid28512424-4] Cassiman C, Casteels I, Stalmans P, Legius E, Jacob J (2017). "Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1". Case Rep Ophthalmol. 8 (1): 214–220. doi:10.1159/000469702. PMC 5422752. PMID 28512424.

[Evans2000-5] Evans, D G. R (2000). "Neurofibromatosis type 2". Journal of Medical Genetics. 37 (12): 897–904. doi:10.1136/jmg.37.12.897. ISSN 1468-6244.

[pmid17555581-6] Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X (2007). "Fibromuscular dysplasia". Orphanet J Rare Dis. 2: 28. doi:10.1186/1750-1172-2-28. PMC 1899482. PMID 17555581.

[pmid27824552-7] Gazit Y, Jacob G, Grahame R (2016). "Ehlers-Danlos Syndrome-Hypermobility Type: A Much Neglected Multisystemic Disorder". Rambam Maimonides Med J. 7 (4). doi:10.5041/RMMJ.10261. PMC 5101008. PMID 27824552.

[pmid18390527-8] Michet CJ, Matteson EL (2008). "Polymyalgia rheumatica". BMJ. 336 (7647): 765–9. doi:10.1136/bmj.39514.653588.80. PMC 2287267. PMID 18390527.

[pmid23227278-9] Baker KR, Rice L (2012). "The amyloidoses: clinical features, diagnosis and treatment". Methodist Debakey Cardiovasc J. 8 (3): 3–7. PMC 3487569. PMID 23227278.

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@@ Line 19: / Line 19: @@
 *[[Wegener granulomatosis]]
-{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
+<span style="font-size:85%">'''Abbreviations:'''
+ABG= [[Arterial blood gas]], ANA= [[Antinuclear antibody]], ANP= [[Atrial natriuretic peptide]], ASO= [[Antistreptolysin O|Antistreptolysin O antibody]], BNP= [[Brain natriuretic peptide]], CBC= [[Complete blood count]], COPD= [[Chronic obstructive pulmonary disease]], CRP= [[C-reactive protein]], CT= [[Computed tomography]], CXR= [[Chest X-ray]], DVT= [[Deep vein thrombosis]], ESR= [[Erythrocyte sedimentation rate]], HRCT= [[High Resolution CT]], IgE= [[Immunoglobulin E]], LDH= [[Lactate dehydrogenase]], PCWP= [[Pulmonary capillary wedge pressure]], PCR= [[Polymerase chain reaction]], PFT= [[Pulmonary function test]].</span>
+{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
 ! colspan="3" rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Diseases
 | colspan="8" rowspan="1" style="background:#4479BA; color: #FFFFFF;" align="center" |'''Clinical manifestations'''
@@ Line 50: / Line 52: @@
 ! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
 |-
-! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" align="center" |
+! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" align="center" |Large-Vessel Vasculitis
+! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Takayasu arteritis]]<ref name="pmid23626437">{{cite journal| author=Vaideeswar P, Deshpande JR| title=Pathology of Takayasu arteritis: A brief review. | journal=Ann Pediatr Cardiol | year= 2013 | volume= 6 | issue= 1 | pages= 52-8 | pmid=23626437 | doi=10.4103/0974-2069.107235 | pmc=3634248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23626437  }}</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" |[[MMP|MMP-3]] and [[Matrix metalloproteinase|MMP-9]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Anemia]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[CRP]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aneurysm|Aneurysmal dilatation]] of the [[aorta]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Blood vessel]] [[stenosis]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Circumferential thickening of the [[arterial]] wall (Macaroni sign)
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[PET scan|PET-scan]], [[Cardiac]] [[CT]]
+![[Granulomatous]] [[inflammation]] of [[arteries]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Arteriography]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary aneurysm]]
+|-
 ! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Giant cell arteritis]]<ref name="pmid13679546">{{cite journal| author=Calvo-Romero JM| title=Giant cell arteritis. | journal=Postgrad Med J | year= 2003 | volume= 79 | issue= 935 | pages= 511-5 | pmid=13679546 | doi= | pmc=1742823 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13679546  }}</ref>
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
@@ Line 72: / Line 95: @@
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Jaw pain]] and [[Jaw claudication|claudication]]
 |-
-! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polymyalgia rheumatica|Polymyalgia rheumatica (PMR)]]<ref name="pmid18390527">{{cite journal| author=Michet CJ, Matteson EL| title=Polymyalgia rheumatica. | journal=BMJ | year= 2008 | volume= 336 | issue= 7647 | pages= 765-9 | pmid=18390527 | doi=10.1136/bmj.39514.653588.80 | pmc=2287267 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18390527  }}</ref>
+! rowspan="3" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurological disease]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cerebral aneurysm]]<ref name="pmid20557771">{{cite journal| author=Stafa A, Leonardi M| title=Role of neuroradiology in evaluating cerebral aneurysms. | journal=Interv Neuroradiol | year= 2008 | volume= 14 Suppl 1 | issue=  | pages= 23-37 | pmid=20557771 | doi=10.1177/15910199080140S106 | pmc=3328052 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20557771  }}</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" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Well-defined round, slightly hyperattenuating lesion
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Bulging out of the [[Lumen|main lumen]]
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Heterogeneous]] signal intensity in [[Magnetic resonance angiography|MRA]]
+!Layers of [[smooth muscle cells]], Intact [[endothelium]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Digital subtraction angiography|Digital subtraction angiography (DSA)]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Nausea]], [[Vomiting]]
+|-
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Neurofibromatosis type 1]]<ref name="pmid28512424">{{cite journal| author=Cassiman C, Casteels I, Stalmans P, Legius E, Jacob J| title=Optical Coherence Tomography Angiography of Retinal Microvascular Changes Overlying Choroidal Nodules in Neurofibromatosis Type 1. | journal=Case Rep Ophthalmol | year= 2017 | volume= 8 | issue= 1 | pages= 214-220 | pmid=28512424 | doi=10.1159/000469702 | pmc=5422752 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28512424  }}</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" |[[Fibrinogen|Plasma fibrinogen]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Normocytic normochromic anemia|Normocytic, normochromic anemia]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[CRP]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Odontoid process|Periodontoid]] localization of [[calcification]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Vessel wall]] thickening, Increased mural contrast enhancement
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Subacromial bursitis|Subacromial]] or subdeltoid [[bursitis]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |High [[Fluorescein sodium|F-FDG]] accumulation around the [[joints]] in [[Positron emission tomography|FDG PET-CT]]
-!Small angular fibers, [[Pyknosis|Pyknotic]] [[nuclear]] clumps, or target-targetoid fibers
 ! 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" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[NF1|NF1 mutated gene]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Neurofibromin|Neurofibromin gene]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bone disease|Bone abnormalities]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Optical coherence tomography angiography (OCTA)
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Optic nerve gliomas]] in [[MRI]]
+!Elongated spindle-shaped [[cells]] in [[Neurofibroma|neurofibromas]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[National Institutes of Health|NIH]] [[diagnostic criteria]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Café au lait spot|Cafe au Lait spot]]
 |-
-! 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: #DCDCDC;" align="center" |[[Neurofibromatosis type 2]]<ref name="Evans2000">{{cite journal|last1=Evans|first1=D G. R|title=Neurofibromatosis type 2|journal=Journal of Medical Genetics|volume=37|issue=12|year=2000|pages=897–904|issn=14686244|doi=10.1136/jmg.37.12.897}}</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" |-
 ! 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" |[[NF2 gene|NF2 mutated gene]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Normochromic anemia|Normochromic normocytic anemia]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]], [[Hypoalbuminemia]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Merlin (protein)|Schwannomin]]
-! 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" |[[Meningioma]], [[Schwannoma]], [[Ependymoma]]
-! 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" |[[Fluorescein angiography]] showed [[retinal]] [[hamartoma]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Localized [[schwannomas]] in nerve [[ultrasound]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Single or multiple [[nodules]] and [[Mass|masses]] with [[cavitation]] in [[CXR]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Schwannoma]] in [[MRI]]
-![[Parenchymal]] [[necrosis]], [[Granulomatous]] [[inflammation]]
+!Encapsulated biphasic [[nerve sheath]] [[tumor]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Histopathology|Histological confirmation]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[National Institutes of Health|NIH]] [[diagnostic criteria]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Conjunctivitis]],
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hearing loss]], [[Vision loss]]
-[[Episcleritis]],
-[[Uveitis]],
-[[Optic nerve]] vasculitis
 |-
-! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polyarteritis nodosa]]<ref name="pmid25770638">{{cite journal| author=Howard T, Ahmad K, Swanson JA, Misra S| title=Polyarteritis nodosa. | journal=Tech Vasc Interv Radiol | year= 2014 | volume= 17 | issue= 4 | pages= 247-51 | pmid=25770638 | doi=10.1053/j.tvir.2014.11.005 | pmc=4363102 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25770638  }}</ref>
+! rowspan="4" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Systemic disease]]
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Fibromuscular dysplasia]]<ref name="pmid17555581">{{cite journal| author=Plouin PF, Perdu J, La Batide-Alanore A, Boutouyrie P, Gimenez-Roqueplo AP, Jeunemaitre X| title=Fibromuscular dysplasia. | journal=Orphanet J Rare Dis | year= 2007 | volume= 2 | issue=  | pages= 28 | pmid=17555581 | doi=10.1186/1750-1172-2-28 | pmc=1899482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17555581  }}</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" |[[Transforming growth factor β|Transforming growth factor β (TGF-β)]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ [[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Alternating [[stenosis]] and [[Dilatation|dilatations]] in [[CT angiography]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Stenosis]] in the [[renal arteries]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Luminal narrowing alternating with [[dilatation]] (Beads sign)
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Focal [[concentric]], long-segment [[tubular]] [[stenosis]] or outpouching in [[MRA]]
+!Fibrodysplastic changes, [[Collagen]] deposition
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Digital subtraction angiography|Digital subtraction angiography (DSA)]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Spontaneous coronary artery dissection|Spontaneous coronary artery dissection (SCAD)]]
+|-
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Ehlers-Danlos syndrome]]<ref name="pmid27824552">{{cite journal| author=Gazit Y, Jacob G, Grahame R| title=Ehlers-Danlos Syndrome-Hypermobility Type: A Much Neglected Multisystemic Disorder. | journal=Rambam Maimonides Med J | year= 2016 | volume= 7 | issue= 4 | pages=  | pmid=27824552 | doi=10.5041/RMMJ.10261 | pmc=5101008 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27824552  }}</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" |[[LAMP2|LAMP-2 protein autoantibodies]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Normochromic anemia]], [[Thrombocytosis]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ [[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]],
-↑ [[ALT]] or [[AST]], [[Proteinuria]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Focal regions of [[infarction]] or [[hemorrhage]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Multiple [[Aneurysm|microaneurysms]],  [[Hemorrhage]] due to focal [[rupture]], [[Occlusion]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aneurysms]] and [[renal]] [[arteriovenous fistula]] in [[Doppler sonography|color Doppler sonography]]
 ! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
-![[Necrotizing]] [[inflammatory]] lesions
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Angiography]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[TGF-β]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Sudden [[weight loss]], [[Abdominal pain]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Cultured skin [[fibroblasts]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Multiple [[vascular]] segments with [[aneurysms]] and [[dissections]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Dissection]] of the [[Circumflex branch of left coronary artery|posterolateral branch of the left circumflex coronary artery (LCx)]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Visceral]] [[arteries]] abnormality
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Vascular anomaly|Vascular abnormalities]] in [[MRA]]
+!Thin and rare [[collagen]] bundles in the [[dermis]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |History and [[physical examination]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Bleeding]], [[Easy bruising|Bruisability]], [[Heart murmur]]
 |-
-! colspan="2" style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Takayasu arteritis]]<ref name="pmid23626437">{{cite journal| author=Vaideeswar P, Deshpande JR| title=Pathology of Takayasu arteritis: A brief review. | journal=Ann Pediatr Cardiol | year= 2013 | volume= 6 | issue= 1 | pages= 52-8 | pmid=23626437 | doi=10.4103/0974-2069.107235 | pmc=3634248 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23626437  }}</ref>
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Polymyalgia rheumatica|Polymyalgia rheumatica (PMR)]]<ref name="pmid18390527">{{cite journal| author=Michet CJ, Matteson EL| title=Polymyalgia rheumatica. | journal=BMJ | year= 2008 | volume= 336 | issue= 7647 | pages= 765-9 | pmid=18390527 | doi=10.1136/bmj.39514.653588.80 | pmc=2287267 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18390527  }}</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" |[[Fibrinogen|Plasma fibrinogen]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Normocytic normochromic anemia|Normocytic, normochromic anemia]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[CRP]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Odontoid process|Periodontoid]] localization of [[calcification]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Vessel wall]] thickening, Increased mural contrast enhancement
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Subacromial bursitis|Subacromial]] or subdeltoid [[bursitis]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |High [[Fluorescein sodium|F-FDG]] accumulation around the [[joints]] in [[Positron emission tomography|FDG PET-CT]]
+!Small angular fibers, [[Pyknosis|Pyknotic]] [[nuclear]] clumps, or target-targetoid fibers
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Joint stiffness]], [[Fatigue]]
+|-
+! style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Amyloidosis]]<ref name="pmid23227278">{{cite journal| author=Baker KR, Rice L| title=The amyloidoses: clinical features, diagnosis and treatment. | journal=Methodist Debakey Cardiovasc J | year= 2012 | volume= 8 | issue= 3 | pages= 3-7 | pmid=23227278 | doi= | pmc=3487569 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23227278  }}</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" |+/-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Immunoglobulin light chains|Immunoglobulin light chain]][[Amyloid beta|(Amyloid)]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |+/-
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Anemia]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[MMP|MMP-3]] and [[Matrix metalloproteinase|MMP-9]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Leukocytosis]], [[Anemia]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑ [[Creatinine|Cr]] or [[Blood urea nitrogen|BUN]],
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑
+↑ [[ALT]] or [[AST]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |↑[[CRP]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Diffusely hypoattenuating and enlarged [[liver]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Aneurysm|Aneurysmal dilatation]] of the [[aorta]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Amyloid]] deposition in the media and [[adventitia]] of small arteries
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Blood vessel]] [[stenosis]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Solid organs increased [[echogenicity]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Circumferential thickening of the [[arterial]] wall (Macaroni sign)
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Tc-DPD for [[cardiac]] '''[[amyloid]]''' deposits
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[PET scan|PET-scan]], [[Cardiac]] [[CT]]
+![[Extracellular]] deposition of [[Fibrillarin|fibrillar proteins]]
-![[Granulomatous]] [[inflammation]] of [[arteries]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Biopsy]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Arteriography]]
+! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Cardiomegaly]], [[Dyspnea]]
-! style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Coronary aneurysm]]
 |-
 |}

Differentiating Temporal arteritis from other diseases: Difference between revisions

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Differentiating Temporal Arteritis from other Diseases

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