Hubert de Boysson1,2, Eric Liozon3,4, Delphine Larivière3,4, Maxime Samson3,4, Jean-Jacques Parienti3,4, Jonathan Boutemy3,4, Gwénola Maigné3,4, Nicolas Martin Silva3,4, Kim Ly3,4, Emmanuel Touzé3,4, Bernard Bonnotte3,4, Achille Aouba3,4, Karim Sacré3,4, Boris Bienvenu3,4. 1. From the Department of Internal Medicine, and Biostatistics and Clinical Research Unit, and Department of Neurology, Caen University Hospital; University of Caen, Basse Normandie; University of Caen-Normandie, Inserm U919, Caen; Department of Internal Medicine, Limoges University Hospital, Limoges; Department of Internal Medicine, Bichat University Hospital, Paris; Department of Internal Medicine, Dijon University Hospital, Dijon, France. deboysson-h@chu-caen.fr. 2. H. de Boysson, MD, MSc, Department of Internal Medicine, Caen University Hospital, and University of Caen, Basse Normandie; E. Liozon, MD, Department of Internal Medicine, Limoges University Hospital; D. Larivière, MD, Department of Internal Medicine, Bichat University Hospital; M. Samson, MD, PhD, Department of Internal Medicine, Dijon University Hospital; J.J. Parienti, MD, PhD, Biostatistics and Clinical Research Unit, Caen University Hospital; J. Boutemy, MD, Department of Internal Medicine, Caen University Hospital; G. Maigné, MD, Department of Internal Medicine, Caen University Hospital; N. Martin Silva, MD, Department of Internal Medicine, Caen University Hospital; K. Ly, MD, PhD, Department of Internal Medicine, Limoges University Hospital; E. Touzé, MD, PhD, Department of Neurology, Caen University Hospital, and University of Caen-Normandie, Inserm U919; B. Bonnotte, MD, PhD, Department of Internal Medicine, Dijon University Hospital; A. Aouba, MD, PhD, Department of Internal Medicine, Caen University Hospital, and University of Caen, Basse Normandie; K. Sacré, MD, PhD, Department of Internal Medicine, Bichat University Hospital; B. Bienvenu, MD, PhD, Department of Internal Medicine, Caen University Hospital, and University of Caen, Basse Normandie. deboysson-h@chu-caen.fr. 3. From the Department of Internal Medicine, and Biostatistics and Clinical Research Unit, and Department of Neurology, Caen University Hospital; University of Caen, Basse Normandie; University of Caen-Normandie, Inserm U919, Caen; Department of Internal Medicine, Limoges University Hospital, Limoges; Department of Internal Medicine, Bichat University Hospital, Paris; Department of Internal Medicine, Dijon University Hospital, Dijon, France. 4. H. de Boysson, MD, MSc, Department of Internal Medicine, Caen University Hospital, and University of Caen, Basse Normandie; E. Liozon, MD, Department of Internal Medicine, Limoges University Hospital; D. Larivière, MD, Department of Internal Medicine, Bichat University Hospital; M. Samson, MD, PhD, Department of Internal Medicine, Dijon University Hospital; J.J. Parienti, MD, PhD, Biostatistics and Clinical Research Unit, Caen University Hospital; J. Boutemy, MD, Department of Internal Medicine, Caen University Hospital; G. Maigné, MD, Department of Internal Medicine, Caen University Hospital; N. Martin Silva, MD, Department of Internal Medicine, Caen University Hospital; K. Ly, MD, PhD, Department of Internal Medicine, Limoges University Hospital; E. Touzé, MD, PhD, Department of Neurology, Caen University Hospital, and University of Caen-Normandie, Inserm U919; B. Bonnotte, MD, PhD, Department of Internal Medicine, Dijon University Hospital; A. Aouba, MD, PhD, Department of Internal Medicine, Caen University Hospital, and University of Caen, Basse Normandie; K. Sacré, MD, PhD, Department of Internal Medicine, Bichat University Hospital; B. Bienvenu, MD, PhD, Department of Internal Medicine, Caen University Hospital, and University of Caen, Basse Normandie.
Abstract
OBJECTIVE: Our aim was to describe patients with giant cell arteritis (GCA)-related stroke and to compare them with a control group of GCA patients without stroke. METHODS: We created a retrospective multicenter cohort of patients with (1) GCA diagnosed according to the American College of Rheumatology criteria between 1995 and 2015, and (2) stroke occurring at the time of GCA diagnosis or occurring within 4 weeks of starting GCA therapy. The control group consisted of GCA patients without stroke. RESULTS: Forty patients [21 women (53%), median age 78 (60-91) yrs] with GCA-related stroke were included and were compared with 200 control patients. Stroke occurred at GCA diagnosis in 29 patients (73%), whereas it occurred after diagnosis in 11 patients. Vertebrobasilar territory was involved in 29 patients (73%). Seven patients died within a few hours or days following stroke. Compared with the control group, stroke patients had more ophthalmic ischemic symptoms [25 (63%) vs 50 (25%), p < 0.001]. Conversely, they demonstrated lower biological inflammatory variables [C-reactive protein: 61 (28-185) mg/l vs 99 (6-400) mg/l, p = 0.04] and less anemia [22/37 (59%) vs 137/167 (79%), p = 0.03] than patients without stroke. Multivariate logistic regression revealed that the best predictors for the occurrence of stroke were the presence of ophthalmic ischemic symptoms at diagnosis (OR 5, 95% CI 2.14-12.33, p = 0.0002) and the absence of anemia (OR 0.39, 95% CI 0.16-0.99, p = 0.04). CONCLUSION: Stroke, especially in the vertebrobasilar territory, is more likely to occur in patients with GCA who experience recent ophthalmic ischemic symptoms and who exhibit low inflammatory variables.
OBJECTIVE: Our aim was to describe patients with giant cell arteritis (GCA)-related stroke and to compare them with a control group of GCA patients without stroke. METHODS: We created a retrospective multicenter cohort of patients with (1) GCA diagnosed according to the American College of Rheumatology criteria between 1995 and 2015, and (2) stroke occurring at the time of GCA diagnosis or occurring within 4 weeks of starting GCA therapy. The control group consisted of GCA patients without stroke. RESULTS: Forty patients [21 women (53%), median age 78 (60-91) yrs] with GCA-related stroke were included and were compared with 200 control patients. Stroke occurred at GCA diagnosis in 29 patients (73%), whereas it occurred after diagnosis in 11 patients. Vertebrobasilar territory was involved in 29 patients (73%). Seven patients died within a few hours or days following stroke. Compared with the control group, strokepatients had more ophthalmic ischemic symptoms [25 (63%) vs 50 (25%), p < 0.001]. Conversely, they demonstrated lower biological inflammatory variables [C-reactive protein: 61 (28-185) mg/l vs 99 (6-400) mg/l, p = 0.04] and less anemia [22/37 (59%) vs 137/167 (79%), p = 0.03] than patients without stroke. Multivariate logistic regression revealed that the best predictors for the occurrence of stroke were the presence of ophthalmic ischemic symptoms at diagnosis (OR 5, 95% CI 2.14-12.33, p = 0.0002) and the absence of anemia (OR 0.39, 95% CI 0.16-0.99, p = 0.04). CONCLUSION:Stroke, especially in the vertebrobasilar territory, is more likely to occur in patients with GCA who experience recent ophthalmic ischemic symptoms and who exhibit low inflammatory variables.
Authors: B Peral-Cagigal; Á Pérez-Villar; L-M Redondo-González; C García-Sierra; M Morante-Silva; B Madrigal-Rubiales; A Verrier-Hernández Journal: Med Oral Patol Oral Cir Bucal Date: 2018-05-01
Authors: Hélène Greigert; André Ramon; Georges Tarris; Laurent Martin; Bernard Bonnotte; Maxime Samson Journal: J Clin Med Date: 2022-01-05 Impact factor: 4.241
Authors: Kornelis S M van der Geest; Maria Sandovici; Yannick van Sleen; Jan-Stephan Sanders; Nicolaas A Bos; Wayel H Abdulahad; Coen A Stegeman; Peter Heeringa; Abraham Rutgers; Cees G M Kallenberg; Annemieke M H Boots; Elisabeth Brouwer Journal: Arthritis Rheumatol Date: 2018-07-30 Impact factor: 10.995