Compromiso de grandes vasos en arteritis de células gigantes | Seminarios de la Fundación Española de Reumatología

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Peiteado López" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Antonio" "apellidos" => "Torrijos Eslava" ] 1 => array:2 [ "nombre" => "Cristina" "apellidos" => "Bohórquez Heras" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Peiteado López" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1577356605744845?idApp=UINPBA00004N" "url" => "/15773566/0000000600000002/v1_201305151550/S1577356605744845/v1_201305151550/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "Revisiones" "titulo" => "Compromiso de grandes vasos en arteritis de células gigantes" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "63" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Federico Ceccato, Sergio O. Paira" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Federico" "apellidos" => "Ceccato" ] 1 => array:2 [ "nombre" => "Sergio O." "apellidos" => "Paira" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Sección Reumatología. Hospital J.M. Cullen. Santa Fe. Argentina" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec161563" "palabras" => array:3 [ 0 => "Arteritis de células gigantes extracraneal" 1 => "Aneurismas/disección aórtica" 2 => "Síndrome del arco aórtico" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec161564" "palabras" => array:3 [ 0 => "Extracranial giant cell arteritis" 1 => "Aortic arch syndrome" 2 => "Aortic aneurysm/dissection" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "La arteritis de células gigantes es la vasculitis más frecuente en ancianos, y afecta predominantemente a arterias de mediano y gran calibre. El espectro clínico de la arteritis de células gigantes es amplio, y abarca desde las manifestaciones clásicamente descritas, como cefalea, claudicación mandibular, alteraciones visuales y polimialgia reumática, hasta un creciente número de manifestaciones denominadas atípicas. En un 10-15%, la arteritis de células gigantes afecta a la aorta y sus ramas; la región del cayado aórtico y la aorta torácica son las zonas más afectadas. Clínicamente puede manifestarse por insuficiencia aórtica, disnea de esfuerzo y dolor torácico, síndrome del arco aórtico o muerte súbita por disección de la aorta. Este subgrupo afecta en mayor medida a mujeres, más jóvenes que los pacientes con arteritis de células gigantes clásica, con menos síntomas craneales y una mayor frecuencia de biopsias de arteria temporal negativas.Las diferentes técnicas de diagnóstico por imágenes son de gran importancia para el diagnóstico y permitirían evaluar la respuesta al tratamiento.Si bien el tratamiento de elección son los glucocorticoides, no existe consenso acerca de si estos pacientes deben recibir estos fármacos solos o asociados, ni tampoco sobre la dosis de éstos.El mejor conocimiento de lo que sucede en la pared de los vasos en los pacientes con arteritis de células gigantes podrá conducirnos a un mejor enfoque terapéutico, donde el único objetivo no sólo sea reducir los riesgos de la terapia a largo plazo de los glucocorticoides sino también poder tratar de forma eficaz la actividad persistente de la enfermedad." ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Giant Cell Arteritis (GCA), the most common form of vasculitis in the elderly, preferentially involves large and mediumsized arteries. The classic manifestations are headache, jaw claudication, polymyalgia rheumatica and visual symptoms, but some patients present a wide range of clinical manifestations called occult manifestations.Published data indicate that 10% to 15% of GCA cases involve large vessels, most commonly the root of the aorta and its branches. The clinical features are chest pain, aortic regurgitation, disnea, aortic arch syndrome and sudden death. Large vessel GCA emerges as a different variant of this vasculitis, which is more frequently in women with a lack of cranial symptoms and high rate of negative findings on temporal artery biopsy.Imaging procedures are playing an increasingly important role in the evaluation of patients with giant-cell arteritis.Although Giant-cell arteritis can be effectively treated with corticosteroids, there are no established report whether these patients should receive steroids alone or in combination with other drugs.A better understanding of the events that occur in the blood vessel wall of patient diagnosed with GCA might lead to the design of more sophisticated therapeutic approaches. 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Compromiso de grandes vasos en arteritis de células gigantes

Federico Ceccato, Sergio O. Paira

Sección Reumatología. Hospital J.M. Cullen. Santa Fe. Argentina

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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La arteritis de c&#233;lulas gigantes es la vasculitis m&#225;s frecuente en ancianos&#44; y afecta predominantemente a arterias de mediano y gran calibre&#46; El espectro cl&#237;nico de la arteritis de c&#233;lulas gigantes es amplio&#44; y abarca desde las manifestaciones cl&#225;sicamente descritas&#44; como cefalea&#44; claudicaci&#243;n mandibular&#44; alteraciones visuales y polimialgia reum&#225;tica&#44; hasta un creciente n&#250;mero de manifestaciones denominadas at&#237;picas&#46; En un 10-15&#37;&#44; la arteritis de c&#233;lulas gigantes afecta a la aorta y sus ramas&#59; la regi&#243;n del cayado a&#243;rtico y la aorta tor&#225;cica son las zonas m&#225;s afectadas&#46; Cl&#237;nicamente puede manifestarse por insuficiencia a&#243;rtica&#44; disnea de esfuerzo y dolor tor&#225;cico&#44; s&#237;ndrome del arco a&#243;rtico o muerte s&#250;bita por disecci&#243;n de la aorta&#46; Este subgrupo afecta en mayor medida a mujeres&#44; m&#225;s j&#243;venes que los pacientes con arteritis de c&#233;lulas gigantes cl&#225;sica&#44; con menos s&#237;ntomas craneales y una mayor frecuencia de biopsias de arteria temporal negativas&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Las diferentes t&#233;cnicas de diagn&#243;stico por im&#225;genes son de gran importancia para el diagn&#243;stico y permitir&#237;an evaluar la respuesta al tratamiento&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Si bien el tratamiento de elecci&#243;n son los glucocorticoides&#44; no existe consenso acerca de si estos pacientes deben recibir estos f&#225;rmacos solos o asociados&#44; ni tampoco sobre la dosis de &#233;stos&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">El mejor conocimiento de lo que sucede en la pared de los vasos en los pacientes con arteritis de c&#233;lulas gigantes podr&#225; conducirnos a un mejor enfoque terap&#233;utico&#44; donde el &#250;nico objetivo no s&#243;lo sea reducir los riesgos de la terapia a largo plazo de los glucocorticoides sino tambi&#233;n poder tratar de forma eficaz la actividad persistente de la enfermedad&#46;</p>"
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        "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Giant Cell Arteritis &#40;GCA&#41;&#44; the most common form of vasculitis in the elderly&#44; preferentially involves large and mediumsized arteries&#46; The classic manifestations are headache&#44; jaw claudication&#44; polymyalgia rheumatica and visual symptoms&#44; but some patients present a wide range of clinical manifestations called occult manifestations&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Published data indicate that 10&#37; to 15&#37; of GCA cases involve large vessels&#44; most commonly the root of the aorta and its branches&#46; The clinical features are chest pain&#44; aortic regurgitation&#44; disnea&#44; aortic arch syndrome and sudden death&#46; Large vessel GCA emerges as a different variant of this vasculitis&#44; which is more frequently in women with a lack of cranial symptoms and high rate of negative findings on temporal artery biopsy&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Imaging procedures are playing an increasingly important role in the evaluation of patients with giant-cell arteritis&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">Although Giant-cell arteritis can be effectively treated with corticosteroids&#44; there are no established report whether these patients should receive steroids alone or in combination with other drugs&#46;</p><p class="elsevierStyleSimplePara elsevierViewall">A better understanding of the events that occur in the blood vessel wall of patient diagnosed with GCA might lead to the design of more sophisticated therapeutic approaches&#46; These new approaches to GCA would have the goal of reducing the feared complications of insufficiently treated disease&#44; while reducing the risk associated with longstanding corticosteroids therapy in elderly patients&#46;</p>"
      ]
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Información del artículo

ISSN: 15773566
Idioma original: Español

DOI:10.1016/S1577-3566(05)74485-7

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