№ 10Immunology15 min read
Large vessel vasculitides, Polymyalgia rheumatica (classification, pathomechanism, symptoms, treatment)
1. Big picture
This topic has three exam-relevant diseases:
- Giant cell arteritis (GCA) — elderly patient, new headache, jaw claudication, visual symptoms, high erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP).
- Takayasu arteritis (TAK) — young woman, aortic arch/branch inflammation, limb claudication, pulse or blood pressure asymmetry.
- Polymyalgia rheumatica (PMR) — elderly patient, shoulder/hip girdle pain and morning stiffness, high ESR/CRP, dramatic response to low-dose glucocorticoids.
The emergency trap is GCA with visual symptoms: treat immediately with high-dose glucocorticoids; do not wait for biopsy or imaging.
Large-vessel vasculitis
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