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Riesenzellarteriitis

Giant cell arteritis

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Zusammenfassung

Die Riesenzellarteriitis (RZA) ist die in der Gefäßmedizin bedeutsamste systemische Vaskulitis. Fortschritte in der bildgebenden Diagnostik, unter anderem der Sonographie, haben die Diagnosestellung der RZA in den letzten 2 Jahrzehnten dramatisch verbessert. Mit dem Interleukin-6-Rezeptor-Antagonisten Tocilizumab steht das erste spezifisch für die RZA zugelassene Medikament zur Verfügung. Angesichts häufiger kranialer und extrakranialer ischämischer Frühkomplikationen und dem bei dieser Erkrankung deutlich erhöhten Risiko für aortale Spätkomplikationen (insb. Aneurysma und Dissektion der thorakalen Aorta) ist der vaskuläre Mediziner heutzutage gefragt wie nie zuvor im interdisziplinären Management dieser Erkrankung.

Abstract

Giant cell arteritis (GCA) is the most important form of systemic vasculitis in Vascular Medicine. Major advances in diagnostic imaging including sonography have significantly improved the diagnosis of GCA in the past two decades. Nonetheless, temporal artery biopsy still plays a role in the diagnostic work-up of suspected GCA. The interleukin-6 receptor antagonist tocilizumab is the first promising treatment option for GCA since the introduction of corticosteroids. Early ischemic complications not only affect the eyes but also frequently the extremities and there is a substantial risk of late thoracic aortic complications (e.g. aneurysm and dissection). Given the advances in the understanding of this systemic vascular disease, the vascular medical specialist nowadays plays an important role in the interdisciplinary management of GCA.

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Authors and Affiliations

  1. Sektion Angiologie – Gefäßzentrum, Med. Klinik und Poliklinik IV, Klinikum, Ludwig-Maximilians-Universität München, Pettenkoferstraße 8a, 80336, München, Deutschland

    M. Czihal & U. Hoffmann

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  1. M. Czihal
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Correspondence to M. Czihal.

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Interessenkonflikt

M. Czihal gibt an, Vortragshonorare von der Fa. Roche erhalten zu haben. U. Hoffmann gibt, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Czihal, M., Hoffmann, U. Riesenzellarteriitis. Gefässchirurgie 24, 128–134 (2019). https://doi.org/10.1007/s00772-019-0503-3

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