Differentiating Temporal arteritis from other diseases: Difference between revisions

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! style="background:#4479BA; color: #FFFFFF;" align="center" |Ultrasound/ Echocardiography
! style="background:#4479BA; color: #FFFFFF;" align="center" |Ultrasound/ Echocardiography
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
! style="background:#4479BA; color: #FFFFFF;" align="center" |Other
|-
! 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>
! 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>
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[[Optic nerve]] vasculitis
[[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>
! 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" |[[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" |[[Angiography]]
! style="padding: 5px 5px; background: #F5F5F5;" align="center" |Sudden [[weight loss]], [[Abdominal pain]]
|-
! rowspan="9" style="padding: 5px 5px; background: #DCDCDC;" align="center" |
! 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]]


==References==
==References==

Revision as of 02:05, 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
Giant cell arteritis[1] + - + +/- - - - +/- 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)[2] + - +/- + - - - - 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)[3] + +/- +/- - - - - + 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

Polyarteritis nodosa[4] + + + + + + +/- +/- LAMP-2 protein autoantibodies Leukocytosis, Normochromic anemia, Thrombocytosis ↑ ↑ Cr or BUN,

↑ ALT or AST, Proteinuria

Focal regions of infarction or hemorrhage Multiple microaneurysms, Hemorrhage due to focal rupture, Occlusion Aneurysms and renal arteriovenous fistula in color Doppler sonography - Necrotizing inflammatory lesions Angiography Sudden weight loss, Abdominal pain
Takayasu arteritis[5] + +/- + - + + +/- +/- 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

References

  1. ↑ Calvo-Romero JM (2003). "Giant cell arteritis". Postgrad Med J. 79 (935): 511–5. PMC 1742823. PMID 13679546.
  2. ↑ Michet CJ, Matteson EL (2008). "Polymyalgia rheumatica". BMJ. 336 (7647): 765–9. doi:10.1136/bmj.39514.653588.80. PMC 2287267. PMID 18390527.
  3. ↑ 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.
  4. ↑ Howard T, Ahmad K, Swanson JA, Misra S (2014). "Polyarteritis nodosa". Tech Vasc Interv Radiol. 17 (4): 247–51. doi:10.1053/j.tvir.2014.11.005. PMC 4363102. PMID 25770638.
  5. ↑ 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.


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