Outcome and prognosis of isolated carotid vasculitis

IF 7.9 1区医学 Q1 IMMUNOLOGY

Journal of autoimmunity Pub Date : 2024-05-17 DOI:10.1016/j.jaut.2024.103242

A. Hankard , G. Maalouf , J. Laouni , O. Espitia , C. Agard , H. De Boysson , A. Aouba , K. Sacré , T. Papo , G. Leroux , M. Vautier , A.C. Desbois , F. Domont , A. Le Joncour , A. Mirouse , L. Chiche , Y. Skaff , J. Gaudric , S. Boussouar , A. Redheuil , D. Saadoun

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引用次数: 0

Abstract

Objective

To assess the prognosis and outcome of patients with isolated carotid vasculitis.

Methods

We performed a retrospective multicenter study of 36 patients (median age at diagnosis was 37 [IQR 27–45] years and 11 [31 %] patients were men) with initial presentation as isolated carotid vasculitis. Study endpoints included vascular complications, relapses, and progression to large vessel vasculitis (i.e. Giant cell arteritis or Takayasu).

Results

The most frequent involvement was the left internal carotid artery (39 %), and 81 % had stenosis. After a median follow-up of 32 months [IQR 12–96], 21 (58 %) patients had a vascular event, including 31 % of new onset vascular lesions and 25 % of stroke/transient ischemic attack. Patients with stroke had less carotidynia at diagnosis (33 % vs 74 %, p = 0.046), higher significant carotid stenosis (i.e. > 50 %) (89 % vs. 30 %, p = 0.026) and higher severe carotid stenosis (i.e. >70 %) (67 % vs 19 %, p = 0.012), compared to those without stroke. Twenty (52 %) patients experienced relapses. High CRP at diagnosis was associated with relapses (p = 0.022). At the end of follow-up, 21 (58 %) patients were classified as having Takayasu arteritis, 13 (36 %) as isolated carotid vasculitis, and two (6 %) as giant cell arteritis.

Conclusion

Carotid vasculitis may occur as a topographically limited lesion and is associated with significant rate of vascular complications.

查看原文本刊更多论文

孤立性颈动脉血管炎的结果和预后。

目的：评估孤立性颈动脉血管炎患者的预后和结局：评估孤立性颈动脉血管炎患者的预后和结局：我们对最初表现为孤立性颈动脉血管炎的 36 名患者（诊断时的中位年龄为 37 [IQR 27-45] 岁，男性患者为 11 [31%]）进行了回顾性多中心研究。研究终点包括血管并发症、复发和发展为大血管炎（即巨细胞动脉炎或高安症）：最常受累的是左侧颈内动脉（39%），其中81%有狭窄。中位随访32个月[IQR 12-96]后，21名患者（58%）发生了血管事件，其中31%为新发血管病变，25%为中风/短暂性脑缺血发作。与未发生中风的患者相比，中风患者在确诊时颈动脉狭窄程度较轻（33% 对 74%，p = 0.046），颈动脉明显狭窄（即 > 50%）程度较高（89% 对 30%，p = 0.026），颈动脉严重狭窄（即 > 70%）程度较高（67% 对 19%，p = 0.012）。20例（52%）患者复发。诊断时的高 CRP 与复发有关（p = 0.022）。随访结束时，21 名患者（58%）被归类为高安动脉炎，13 名患者（36%）被归类为孤立性颈动脉血管炎，2 名患者（6%）被归类为巨细胞动脉炎：结论：颈动脉血管炎可能是一种局部局限性病变，与血管并发症的发生率有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of autoimmunity 医学-免疫学

CiteScore

27.90

自引率

1.60%

发文量

117

审稿时长

17 days

期刊介绍： The Journal of Autoimmunity serves as the primary publication for research on various facets of autoimmunity. These include topics such as the mechanism of self-recognition, regulation of autoimmune responses, experimental autoimmune diseases, diagnostic tests for autoantibodies, as well as the epidemiology, pathophysiology, and treatment of autoimmune diseases. While the journal covers a wide range of subjects, it emphasizes papers exploring the genetic, molecular biology, and cellular aspects of the field. The Journal of Translational Autoimmunity, on the other hand, is a subsidiary journal of the Journal of Autoimmunity. It focuses specifically on translating scientific discoveries in autoimmunity into clinical applications and practical solutions. By highlighting research that bridges the gap between basic science and clinical practice, the Journal of Translational Autoimmunity aims to advance the understanding and treatment of autoimmune diseases.