Abstract
To describe the clinical characteristics, management, and outcome of a series of patients with giant cell arteritis (GCA) and inflammatory bowel disease (IBD). Patients with both GCA and IBD evaluated between 1/1/1996 and 12/30/2018 were retrospectively identified. Clinical characteristics, laboratory parameters, radiologic features, histopathology, management and outcomes were abstracted. A systematic literature review identifying patients with IBD and GCA was performed via a Medline and EMBASE search from inception through December 31 2019. Six patients were identified with GCA and IBD (66% male). Five (83%) had ulcerative colitis (UC) and one had Crohn’s disease (CD). Diagnosis of IBD preceded GCA in four patients with an average interval of 30 years (range 14–42). Average time to IBD diagnosis in those with prior GCA diagnosis was 1.5 years. During mean follow-up of 4.3 years, GCA relapse was infrequent with only one patient with relapse observed. Systematic literature review identified six additional patients with confirmed coexistence of GCA and IBD. Similar to the current series, male sex was more common and ulcerative colitis was the predominant IBD phenotype. The current study reports findings from the largest single-institution case-series of co-existent GCA and IBD. In contrast to Takayasu arteritis with co-existent IBD, which displays a predilection for female sex and Crohn’s disease phenotype, both the current study and review of literature demonstrate a stronger association of GCA with male sex and ulcerative colitis. Further studies addressing a potential pathophysiologic connection between GCA and IBD are suggested.
Code availability
Not applicable.
References
Wilson JC et al (2015) Inflammatory bowel disease and the risk of autoimmune diseases. J Crohn’s Colitis 10(2):186–193
Cohen R et al (2008) Autoimmune disease concomitance among inflammatory bowel disease patients in the United States, 2001–2002. Inflamm Bowel Dis 14(6):738–743
Halling ML et al (2017) Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases. World J Gastroenterol 23(33):6137–6146
Sy A et al (2016) Vasculitis in patients with inflammatory bowel diseases: a study of 32 patients and systematic review of the literature. Semin Arthritis Rheum 45(4):475–482
Yavne Y et al (2018) Giant cell arteritis and inflammatory bowel disease - Is there a connection? Results from a population-based study. Autoimmun Rev 17(11):1134–1137
Bernstein CN et al (2016) World gastroenterology organisation global guidelines inflammatory bowel disease: update August 2015. J Clin Gastroenterol 50(10):803–818
Hunder GG et al (1990) The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 33(8):1122–1128
Ronchetto F, Pistono PG (1993) Temporal arteritis in a patient with ulcerative colitis. Coincidental association or (immuno) pathogenetic link? Recent Prog Med 84(1):54–56
Gobron C et al (2010) Unilateral carotid granulomatous arteritis and Crohn's disease. 166(5):542–546.
Jacob A et al (1990) Ulcerative colitis and giant cell arteritis associated with sensorineural deafness. J Laryngol Otol 104(11):889–890
Sanges S et al (2016) Giant cell arteritis and ulcerative colitis: an unusual association. Semin Arthritis Rheum 46(1):e3-5
Watanabe R et al (2016) Giant cell arteritis: from pathogenesis to therapeutic management. Curr Treatm Opt Rheumatol 2(2):126–137
Chandran AK et al (2015) The incidence of giant cell arteritis in Olmsted County, Minnesota, over a 60-year period 1950–2009. Scand J Rheumatol 44(3):215–218
Labarca C et al (2016) Predictors of relapse and treatment outcomes in biopsy-proven giant cell arteritis: a retrospective cohort study. Rheumatology (Oxford) 55(2):347–356
Martinez-Lado L et al (2011) Relapses and recurrences in giant cell arteritis: a population-based study of patients with biopsy-proven disease from northwestern Spain. Medicine (Baltimore) 90(3):186–193
Koster MJ et al (2019) Efficacy of methotrexate in real-world management of giant cell arteritis: a case-control study. J Rheumatol 46(5):501–508
Mahr AD et al (2007) Adjunctive methotrexate for treatment of giant cell arteritis: an individual patient data meta-analysis. Arthritis Rheum 56(8):2789–2797
Koster MJ et al (2018) Large-vessel giant cell arteritis: diagnosis, monitoring and management. Rheumatology 57(suppl_2):ii32-ii42
Koster MJ, Warrington KJ (2017) Classification of large vessel vasculitis: can we separate giant cell arteritis from Takayasu arteritis? Presse Med 46(7–8 Pt 2):e205–e213
Tuckwell K et al (2017) Newly diagnosed vs. relapsing giant cell arteritis: baseline data from the GiACTA trial. Semin Arthritis Rheum 46(5):657–664
Funding
None.
Author information
Authors and Affiliations
Contributions
All authors were involved in the preparation of the manuscript and have approved the manuscript and this submission.
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflicts of interest.
Availability of data and material
Data are available for review if needed/required.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Bekele, D.I., Warrington, K.J. & Koster, M.J. Giant cell arteritis associated with inflammatory bowel disease: a case-series and review of the literature. Rheumatol Int 41, 487–492 (2021). https://doi.org/10.1007/s00296-020-04727-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-020-04727-w