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Großgefäßvaskulitis

Large vessel vasculitis

  • Leitthema
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Der Nephrologe Aims and scope

Zusammenfassung

Die bedeutsamsten Vaskulitiden der großen Gefäße sind die Riesenzellarteriitis, die Takayasu-Arteriitis und die chronische Periaortitis. Diese entzündlichen Systemerkrankungen manifestieren sich an der Aorta und ihren primären Ästen. Bei sehr variabler klinischer Erscheinung und Fehlen spezifischer Biomarker ist die multimodale bildgebende Diagnostik entscheidend für die frühzeitige Diagnosestellung und die Verhinderung von Organkomplikationen. Initial hoch dosierte Glukokortikoide sind nach wie vor Basis der Therapie, aber erst durch den Einsatz von Biologika lässt sich bei vielen Patienten mit Großgefäßvaskulitiden im Langzeitverlauf eine anhaltende Remission bei akzeptabel niedrigen Glukokortikoiddosen erzielen.

Abstract

Giant cell arteritis, Takayasu arteritis and chronic periaortitis are the most important large vessel vasculitides. These systemic inflammatory diseases involve the aorta and its primary branches. They are characterized by a highly variable clinical presentation and the lack of a specific biomarker. Therefore, modern multimodal imaging diagnostics are of utmost importance for the diagnosis and avoidance of organ complications. Glucocorticoids, initially with high daily doses, remain the cornerstone of medicinal treatment. Biological treatment options nowadays offer a perspective of long-term clinical remission at acceptably low glucocorticoid doses for many patients with large vessel vasculitis.

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Authors and Affiliations

  1. Sektion Angiologie – Gefäßzentrum, Medizinische Klinik und Poliklinik IV, LMU Klinikum, Campus Innenstadt, Ziemsenstr. 5, 80336, München, Deutschland

    Michael Czihal & Ulrich Hoffmann

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  1. Michael Czihal
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  2. Ulrich Hoffmann
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Correspondence to Michael Czihal.

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Interessenkonflikt

M. Czihal weist auf folgende Beziehung hin: Vortragshonorare von Roche. U. Hoffmann gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Uwe Heemann, München

Hans-Joachim Anders, München

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Czihal, M., Hoffmann, U. Großgefäßvaskulitis. Nephrologe 16, 350–359 (2021). https://doi.org/10.1007/s11560-021-00537-8

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  • DOI: https://doi.org/10.1007/s11560-021-00537-8

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