Pub Date : 2025-02-25DOI: 10.1016/j.jbspin.2025.105869
Pauline Brevet, Manuel Fréret, Eric Barat, Thierry Lequerré, Olivier Boyer, Olivier Vittecoq
{"title":"Could the anti-modified protein antibody concept help better define seronegative rheumatoid arthritis?","authors":"Pauline Brevet, Manuel Fréret, Eric Barat, Thierry Lequerré, Olivier Boyer, Olivier Vittecoq","doi":"10.1016/j.jbspin.2025.105869","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105869","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105869"},"PeriodicalIF":3.8,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-24DOI: 10.1016/j.jbspin.2025.105864
Anne Tournadre
Recent data suggest a pathophysiological role of aging and immuno-senescence during polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), by definition rheumatic disease of the elderly. During aging, there is a decline in major physiological functions (immune system, muscle, cognitive, endocrine, cardiovascular, respiratory and renal functions), which combined with multi-morbidity, environmental factors and polypharmacy can lead to frailty. Frailty is a clinical syndrome and dynamic concept including a pre-frailty stage; it reflects a reduction in physiological reserve capacities which alters the mechanisms of adaptation to stress. It results in the inability of a vulnerable subject to return to baseline homoeostasis after minor stress, increasing the risk of hospitalization, loss of autonomy and death. To date, there are no consensual criteria for frailty and its assessment in clinical practice remains difficult, based either on physical criteria including weight loss, fatigue, reduction in muscular strength and walking, inactivity or on a multidimensional geriatric assessment. The impact on morbidity and mortality and quality of life, the possibility of detecting reversible stages of pre-frailty and of implementing preventive measures justify interest in rheumatology as the number of patients aged 65 years and older with inflammatory rheumatic diseases is increasing. If there are no specific recommendations for the management of frailty or pre-frailty, recommendations for exercises, physical activity and nutrition to limit sarcopenia and comorbidities can be applied. The association with multi-morbidity and its additive effect reinforces the need for screening, prevention and specific management of comorbidities, particularly infections, osteoporosis, cardiovascular diseases, during chronic inflammatory rheumatic diseases, PMR and GCA.
{"title":"Frailty during polymyalgia rheumatica, giant cell arteritis and other inflammatory rheumatic diseases.","authors":"Anne Tournadre","doi":"10.1016/j.jbspin.2025.105864","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105864","url":null,"abstract":"<p><p>Recent data suggest a pathophysiological role of aging and immuno-senescence during polymyalgia rheumatica (PMR) and giant cell arteritis (GCA), by definition rheumatic disease of the elderly. During aging, there is a decline in major physiological functions (immune system, muscle, cognitive, endocrine, cardiovascular, respiratory and renal functions), which combined with multi-morbidity, environmental factors and polypharmacy can lead to frailty. Frailty is a clinical syndrome and dynamic concept including a pre-frailty stage; it reflects a reduction in physiological reserve capacities which alters the mechanisms of adaptation to stress. It results in the inability of a vulnerable subject to return to baseline homoeostasis after minor stress, increasing the risk of hospitalization, loss of autonomy and death. To date, there are no consensual criteria for frailty and its assessment in clinical practice remains difficult, based either on physical criteria including weight loss, fatigue, reduction in muscular strength and walking, inactivity or on a multidimensional geriatric assessment. The impact on morbidity and mortality and quality of life, the possibility of detecting reversible stages of pre-frailty and of implementing preventive measures justify interest in rheumatology as the number of patients aged 65 years and older with inflammatory rheumatic diseases is increasing. If there are no specific recommendations for the management of frailty or pre-frailty, recommendations for exercises, physical activity and nutrition to limit sarcopenia and comorbidities can be applied. The association with multi-morbidity and its additive effect reinforces the need for screening, prevention and specific management of comorbidities, particularly infections, osteoporosis, cardiovascular diseases, during chronic inflammatory rheumatic diseases, PMR and GCA.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105864"},"PeriodicalIF":3.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1016/j.jbspin.2025.105862
Hélène Greigert, Camil-Cassien Bamdé, André Ramon, Eric Steinmetz, Yannick Béjot, Olivier Bouchot, Bernard Bonnotte, Maxime Samson
Apart from life-threatening and/or functional emergencies, treatment of vascular lesions in giant cell arteritis (GCA) is medical. Revascularization may be considered if the lesion remains symptomatic or progressive despite optimal medical treatment, provided that there is no disease-related inflammation, and always managed by a team of trained experts. The main risk associated with aortic involvement (aortitis) is the development of an aneurysm, most often in the thoracic aorta, after several years of progression. Indications and surgical techniques used to manage these aneurysms follow the recommendations for the general population. In peripheral artery disease, lesions are characterized by parietal thickening, stenosis and sometimes occlusion, which can lead to exertional claudication or chronic permanent ischemia. Open or endovascular surgical management of these stenotic lesions is frequently complicated by restenosis. The role of endovascular techniques in the management of inflammatory lesions is debated, but there is a preference for open surgery, particularly in the lower limbs. Cervical and cerebral arteries also present a risk of stenosis leading to stroke. Balloon dilation and/or stenting of cervical or cerebral arteries during GCA carries a high risk of rupture and restenosis, and remains a rescue treatment limited to certain specific cases of stroke where there are concerns about patient prognosis in the absence of intervention.
{"title":"Giant cell arteritis: role of surgery in the management of vascular complications.","authors":"Hélène Greigert, Camil-Cassien Bamdé, André Ramon, Eric Steinmetz, Yannick Béjot, Olivier Bouchot, Bernard Bonnotte, Maxime Samson","doi":"10.1016/j.jbspin.2025.105862","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105862","url":null,"abstract":"<p><p>Apart from life-threatening and/or functional emergencies, treatment of vascular lesions in giant cell arteritis (GCA) is medical. Revascularization may be considered if the lesion remains symptomatic or progressive despite optimal medical treatment, provided that there is no disease-related inflammation, and always managed by a team of trained experts. The main risk associated with aortic involvement (aortitis) is the development of an aneurysm, most often in the thoracic aorta, after several years of progression. Indications and surgical techniques used to manage these aneurysms follow the recommendations for the general population. In peripheral artery disease, lesions are characterized by parietal thickening, stenosis and sometimes occlusion, which can lead to exertional claudication or chronic permanent ischemia. Open or endovascular surgical management of these stenotic lesions is frequently complicated by restenosis. The role of endovascular techniques in the management of inflammatory lesions is debated, but there is a preference for open surgery, particularly in the lower limbs. Cervical and cerebral arteries also present a risk of stenosis leading to stroke. Balloon dilation and/or stenting of cervical or cerebral arteries during GCA carries a high risk of rupture and restenosis, and remains a rescue treatment limited to certain specific cases of stroke where there are concerns about patient prognosis in the absence of intervention.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105862"},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-19DOI: 10.1016/j.jbspin.2025.105860
Guillermo Carvajal Alegria
{"title":"The role of senescence in polymyalgia rheumatica and giant cell arteritis","authors":"Guillermo Carvajal Alegria","doi":"10.1016/j.jbspin.2025.105860","DOIUrl":"10.1016/j.jbspin.2025.105860","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105860"},"PeriodicalIF":3.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-18DOI: 10.1016/j.jbspin.2025.105854
Sélina Hanna, Tiphaine Dujardin, Philippe Gaudin, Athan Baillet, Xavier Romand
Background/purpose: Combination therapy with methotrexate (MTX) has shown to improve biologic Disease Modifying Rheumatic Drugs (bDMARD) survival in rheumatoid arthritis, but interest in MTX combination therapy in Psoriatic Arthritis (PsA) remains controversial. We conducted a systematic literature review and meta-analysis to study whether a combination therapy bDMARD and MTX improves bDMARD drug survival in PsA.
Methods: We performed a systematic literature review to identify all pertinent articles studying ts/bDMARDs drugs survival (TNF inhibitors (TNFi), IL-17, IL-23, IL-12/23 and JAK inhibitors) and MTX in PsA up until December 2023. Hazard ratio's (HR) were extracted. A random-effect model and inverse-variance method were used. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity and to confirm the robustness of the results.
Results: 2,299 records were identified, and twenty studies were included, with a total of 30,634 patients with PsA. All studies were observational. Two studies involved bDMARDs other than TNFi. Combination therapy with MTX was found to be associated with a superior bDMARDs drug survival (HR = 0.82 [CI95%, 0.75, 0.89], p-value < 0.001, I2=45%) and TNFi drug survival (HR=0.79 [CI95%, 0.73, 0.86], p-value < 0.001, I2=27%). A meta-analysis for non-TNFi was not possible due to the limited number of publications.
Conclusion: This meta-analysis shows the positive association between combination therapy bDMARD with MTX and a better bDMARDs drug survival, especially with TNFi. Further studies are needed to confirm this hypothesis with robust evidence such as randomised controlled trials.
{"title":"bDMARD Drug Survival In Combination Therapy With Methotrexate In Psoriatic Arthritis: a Systematic Literature Review And Meta-analysis.","authors":"Sélina Hanna, Tiphaine Dujardin, Philippe Gaudin, Athan Baillet, Xavier Romand","doi":"10.1016/j.jbspin.2025.105854","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105854","url":null,"abstract":"<p><strong>Background/purpose: </strong>Combination therapy with methotrexate (MTX) has shown to improve biologic Disease Modifying Rheumatic Drugs (bDMARD) survival in rheumatoid arthritis, but interest in MTX combination therapy in Psoriatic Arthritis (PsA) remains controversial. We conducted a systematic literature review and meta-analysis to study whether a combination therapy bDMARD and MTX improves bDMARD drug survival in PsA.</p><p><strong>Methods: </strong>We performed a systematic literature review to identify all pertinent articles studying ts/bDMARDs drugs survival (TNF inhibitors (TNFi), IL-17, IL-23, IL-12/23 and JAK inhibitors) and MTX in PsA up until December 2023. Hazard ratio's (HR) were extracted. A random-effect model and inverse-variance method were used. Sensitivity and subgroup analyses were performed to identify sources of heterogeneity and to confirm the robustness of the results.</p><p><strong>Results: </strong>2,299 records were identified, and twenty studies were included, with a total of 30,634 patients with PsA. All studies were observational. Two studies involved bDMARDs other than TNFi. Combination therapy with MTX was found to be associated with a superior bDMARDs drug survival (HR = 0.82 [CI95%, 0.75, 0.89], p-value < 0.001, I<sup>2</sup>=45%) and TNFi drug survival (HR=0.79 [CI95%, 0.73, 0.86], p-value < 0.001, I<sup>2</sup>=27%). A meta-analysis for non-TNFi was not possible due to the limited number of publications.</p><p><strong>Conclusion: </strong>This meta-analysis shows the positive association between combination therapy bDMARD with MTX and a better bDMARDs drug survival, especially with TNFi. Further studies are needed to confirm this hypothesis with robust evidence such as randomised controlled trials.</p>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105854"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Answer to Dou et al. and to Chen et al.","authors":"Anling Luo, Qin Yang, Zhao Zhang, Yujia Yang, Xuzi Li, Yiting Deng, Li He, Muke Zhou","doi":"10.1016/j.jbspin.2025.105856","DOIUrl":"10.1016/j.jbspin.2025.105856","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105856"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-18DOI: 10.1016/j.jbspin.2025.105857
Jinxiang Peng , Jinmei Tan , Haozhu Chen
{"title":"Comment on: “Association between ankylosing spondylitis and neurodegenerative diseases: Systematic review and meta-analysis” by Luo et al. Joint Bone Spine 2024:105793","authors":"Jinxiang Peng , Jinmei Tan , Haozhu Chen","doi":"10.1016/j.jbspin.2025.105857","DOIUrl":"10.1016/j.jbspin.2025.105857","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105857"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-18DOI: 10.1016/j.jbspin.2025.105859
Shulin Dou, Wei Fang, Wei Wang, Hailiang Wang
{"title":"Exploring the Link Between Ankylosing Spondylitis and Neurodegenerative Diseases: Insights from Mendelian Randomization. Comment on: \"Association between ankylosing spondylitis and neurodegenerative diseases: systematic review and meta-analysis\" by Luo et al. Joint Bone Spine 2024:105793.","authors":"Shulin Dou, Wei Fang, Wei Wang, Hailiang Wang","doi":"10.1016/j.jbspin.2025.105859","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105859","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105859"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-18DOI: 10.1016/j.jbspin.2025.105858
Marie-Eva Pickering , Jean-Claude Souberbielle , Anne Boutten , Véronique Breuil , Karine Briot , Roland Chapurlat , Patrice Fardellone , Rose-Marie Javier , Eugénie Koumakis , Bernard Cortet , Groupe de Recherche et d’Information sur les Ostéoporoses (GRIO)
Advantages and disadvantages of intermittent versus daily vitamin D supplementation especially in adults with or at risk of osteoporosis are discussed by the Osteoporosis Research and Information Group (GRIO). The analysis of the literature suggests that intermittent long-term high doses vitamin D supplementation (such as 60,000 IU/month or more), may increase the risk of falls, fracture and premature death in certain populations, while daily doses of 800–1000 IU with calcium decrease falls and non-vertebral fractures in the elderly with vitamin D deficiency. In patients with or at risk of osteoporosis we hence recommend measuring the 25(OH)D concentration prior to supplementation and to provide vitamin D supplementation (with optimization of calcium intake if needed) to obtain a concentration between 30 and 60 ng/mL. We recommend the use of an initial loading dose, especially in those who need a quick repletion of vitamin D store (symptoms of osteomalacia and/or 25(OH)D concentration < 12 ng/mL, patients eligible for treatment with potent antiresorptive therapy), followed by a maintenance dose. A daily supplementation should be the rule when possible. When daily forms are however not available or not reimbursed, we recommend, like other experts, to continue using intermittent dosing with the smallest available dose (≤ 50,000 IU) and the shortest interval between doses as a stopgap until reimbursement or adequate daily pharmaceutical forms (pills or soft capsules of 1000, 2000 IU) are available.
骨质疏松症研究与信息组(GRIO)讨论了间歇性补充维生素 D 与每日补充维生素 D 的利弊,尤其是对患有骨质疏松症或有骨质疏松症风险的成年人而言。文献分析表明,间歇性长期大剂量补充维生素 D(如每月 60,000 IU 或更多)可能会增加某些人群跌倒、骨折和过早死亡的风险,而每日 800-1000 IU 剂量的维生素 D 和钙可减少维生素 D 缺乏症老人跌倒和非椎体骨折的风险。因此,对于骨质疏松症患者或有骨质疏松症风险的患者,我们建议在补充维生素 D 之前测量 25(OH)D 浓度,并补充维生素 D(必要时优化钙摄入量),以获得 30 至 60 纳克/毫升的浓度。我们建议使用初始负荷剂量,尤其是对于那些需要快速补充维生素 D 的人群(骨软化症状和/或 25(OH)D 浓度在 30 至 60 纳克/毫升之间)。
{"title":"Daily or intermittent vitamin D supplementation in patients with or at risk of osteoporosis: Position statement from the GRIO","authors":"Marie-Eva Pickering , Jean-Claude Souberbielle , Anne Boutten , Véronique Breuil , Karine Briot , Roland Chapurlat , Patrice Fardellone , Rose-Marie Javier , Eugénie Koumakis , Bernard Cortet , Groupe de Recherche et d’Information sur les Ostéoporoses (GRIO)","doi":"10.1016/j.jbspin.2025.105858","DOIUrl":"10.1016/j.jbspin.2025.105858","url":null,"abstract":"<div><div>Advantages and disadvantages of intermittent versus daily vitamin D supplementation especially in adults with or at risk of osteoporosis are discussed by the Osteoporosis Research and Information Group (GRIO). The analysis of the literature suggests that intermittent long-term high doses vitamin D supplementation (such as 60,000<!--> <!-->IU/month or more), may increase the risk of falls, fracture and premature death in certain populations, while daily doses of 800–1000<!--> <!-->IU with calcium decrease falls and non-vertebral fractures in the elderly with vitamin D deficiency. In patients with or at risk of osteoporosis we hence recommend measuring the 25(OH)D concentration prior to supplementation and to provide vitamin D supplementation (with optimization of calcium intake if needed) to obtain a concentration between 30 and 60<!--> <!-->ng/mL. We recommend the use of an initial loading dose, especially in those who need a quick repletion of vitamin D store (symptoms of osteomalacia and/or 25(OH)D concentration <<!--> <!-->12<!--> <!-->ng/mL, patients eligible for treatment with potent antiresorptive therapy), followed by a maintenance dose. A daily supplementation should be the rule when possible. When daily forms are however not available or not reimbursed, we recommend, like other experts, to continue using intermittent dosing with the smallest available dose (≤<!--> <!-->50,000<!--> <!-->IU) and the shortest interval between doses as a stopgap until reimbursement or adequate daily pharmaceutical forms (pills or soft capsules of 1000, 2000<!--> <!-->IU) are available.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105858"},"PeriodicalIF":3.8,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-13DOI: 10.1016/j.jbspin.2025.105855
Robin Arcani , Tatiana Horowitz , Pierre-André Jarrot , Myriam Debelle , Patrick Villani , Aurélie Daumas
We report the atypical case of giant cell arteritis (GCA) in an 88-year-old woman, whose primary symptom was parotitis. The patient presented with a three-week history of painful bilateral parotid enlargement and mild undated morning headaches that were relieved with acetaminophen, but she did not have classic GCA symptoms such as jaw claudication or scalp tenderness. Biological tests revealed biological inflammation. Parotid glands did not show any structural abnormalities. A Doppler ultrasound of the temporal arteries showed inflammation, and a positron emission tomography/computed tomography scan confirmed hypermetabolism in multiple arteries, including those supplying the parotid glands. Temporal artery biopsy confirmed GCA. The patient was treated with prednisone, leading to a rapid improvement in symptoms and inflammatory markers. This case highlights a rare presentation of GCA, where parotitis is the main symptom. GCA should be considered in elderly patients with persistent inflammation and parotitis, particularly when other common causes are ruled out.
{"title":"Bilateral parotitis revealing giant cell arteritis: A case report","authors":"Robin Arcani , Tatiana Horowitz , Pierre-André Jarrot , Myriam Debelle , Patrick Villani , Aurélie Daumas","doi":"10.1016/j.jbspin.2025.105855","DOIUrl":"10.1016/j.jbspin.2025.105855","url":null,"abstract":"<div><div>We report the atypical case of giant cell arteritis (GCA) in an 88-year-old woman, whose primary symptom was parotitis. The patient presented with a three-week history of painful bilateral parotid enlargement and mild undated morning headaches that were relieved with acetaminophen, but she did not have classic GCA symptoms such as jaw claudication or scalp tenderness. Biological tests revealed biological inflammation. Parotid glands did not show any structural abnormalities. A Doppler ultrasound of the temporal arteries showed inflammation, and a positron emission tomography/computed tomography scan confirmed hypermetabolism in multiple arteries, including those supplying the parotid glands. Temporal artery biopsy confirmed GCA. The patient was treated with prednisone, leading to a rapid improvement in symptoms and inflammatory markers. This case highlights a rare presentation of GCA, where parotitis is the main symptom. GCA should be considered in elderly patients with persistent inflammation and parotitis, particularly when other common causes are ruled out.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 3","pages":"Article 105855"},"PeriodicalIF":3.8,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}