• Presse Med · Sep 2019

    Review

    [Aortitis in giant cell arteritis: Diagnosis, prognosis and treatment].

    • Antoine Enfrein, Olivier Espitia, Guillaume Bonnard, and Christian Agard.
    • Centre de compétences maladies systémiques et auto-immunes rares, CHU Nantes, Service de médecine interne, 44093 Nantes, France.
    • Presse Med. 2019 Sep 1; 48 (9): 956967956-967.

    AbstractAortitis, defined by aortic parietal thickening, is noted in about 50% of patients with giant cell arteritis (GCA). Aortic structural lesions, ectasia or aneurism, may occur with or without inflammatory aspect of the aorta, sometimes since the diagnosis of GCA, but more frequently during follow-up. Assessment of aortic involvement, which has to be searched in each patient at the diagnosis of GCA, can be assessed using aortic imaging, angio-CT, angio-MRI or PET-CT. Prognosis of aortitis and its complications remains poorly known, but mortality due to serious events like aneurism rupture or aortic dissection, could be potentially reduced with precocious diagnosis and regular monitoring. Treatment of GCA-related aortitis is based on high-dose glucosteroids, with an initial prednisone dose at 0.7 mg/kg/d, as recommended by the French Study Group for large vessel vasculitis (GEFA). Aortic ectasia and aneurisms have to be monitored, in order to propose aortic surgery in the best conditions as possible.Copyright © 2019 Elsevier Masson SAS. All rights reserved.

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