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This article discusses a case of Occult Giant Cell Arteritis (GCA), a rare variant of GCA that primarily affects the eyes. The patient, an 82-year-old Scandinavian woman, presented with visual disturbances and was initially diagnosed with non-arteritic anterior ischemic optic neuropathy (NA-AION). However, further evaluation revealed bilateral optic disc swelling and halo-signs in the temporal arteries, confirming the diagnosis of GCA. Treatment with corticosteroids led to stabilization of the patient's vision. The article emphasizes the importance of ultrasound examinations in detecting Occult GCA, especially in asymptomatic patients or those at risk due to age or demographic factors. [Extracted from the article]

Coronary artery disease (CAD) causes myocardial ischemia, narrowing or occlusion of the lumen. Although great progress has been made in the treatment of CAD, the existing treatment methods do not meet the clinical needs, so it is urgent to find new treatment methods. The aim of this study was to investigate the mechanism of action of miR‐148a‐3p in alleviating CAD by inhibiting vascular endothelial cell injury and to provide new ideas for the treatment of CAD. A cell model was constructed by lipopolysaccharide (LPS) induction of vascular endothelial cells, and a CAD rat model was established by a high‐fat diet and intraperitoneal injection of posterior pituitary hormone. Relevant indices were detected by RT‐qPCR, ELISA, Western blot, MTT, and flow cytometry. The results indicate that in LPS‐induced vascular endothelial cell assays, miR‐148a‐3p inhibited the upregulation of PCSK9, thereby suppressing the NF‐κB signaling pathway and promoting vascular endothelial cell proliferation. Overexpression of PCSK9 and the addition of NF‐κB signaling pathway activator increased vascular endothelial cell apoptosis. In animal experiments, miR‐148a‐3p alleviated the symptoms of CAD rats, whereas overexpression of PCSK9 promoted apoptosis and increased atheromatous plaque area in CAD rats. In conclusion, miR‐148a‐3p inhibits the NF‐κB signaling pathway through downregulation of PCSK9, thereby protecting vascular endothelial cells and alleviating CAD. [ABSTRACT FROM AUTHOR]

The article discusses a case of a 31-year-old Japanese woman with acute digital ischemia due to lupus vasculitis successfully treated with anifrolumab, glucocorticoids, and anticoagulants. The patient exhibited symptoms such as discoloration of fingers and toes, fever, oral ulcers, alopecia, and livedo reticularis. Anifrolumab, a monoclonal antibody against the type I interferon receptor, was added to the treatment regimen, resulting in improvement and prevention of recurrences. The study highlights the efficacy of combining anifrolumab with traditional treatments for severe organ manifestations of systemic lupus erythematosus, specifically in cases of acute digital ischemia due to lupus vasculitis. [Extracted from the article]

Chronic inflammation is increasingly considered as the most important component of vascular aging, contributing to the progression of age‐related cardiovascular diseases. To delay the process of vascular aging, anti‐inflammation may be an effective measure. The anti‐inflammatory factor annexin A1 (ANXA1) is shown to participate in several age‐related diseases; however, its function during vascular aging remains unclear. Here, an ANXA1 knockout (ANXA1−/−) and an endothelial cell‐specific ANXA1 deletion mouse (ANXA1△EC) model are used to investigate the role of ANXA1 in vascular aging. ANXA1 depletion exacerbates vascular remodeling and dysfunction while upregulates age‐ and inflammation‐related protein expression. Conversely, Ac2‐26 (a mimetic peptide of ANXA1) supplementation reverses this phenomenon. Furthermore, long‐term tumor necrosis factor‐alpha (TNF‐α) induction of human umbilical vein endothelial cells (HUVECs) increases cell senescence. Finally, the senescence‐associated secretory phenotype and senescence‐related protein expression, rates of senescence‐β‐galactosidase positivity, cell cycle arrest, cell migration, and tube formation ability are observed in both ANXA1‐knockdown HUVECs and overexpressed ANXA1‐TNF‐α induced senescent HUVECs. They also explore the impact of formyl peptide receptor 2 (a receptor of ANXA1) in an ANXA1 overexpression inflammatory model. These data provide compelling evidence that age‐related inflammation in arteries contributes to senescent endothelial cells that promote vascular aging. [ABSTRACT FROM AUTHOR]

Transient perivascular inflammation of the carotid artery (TIPIC) is a rare vascular disease characterized by inflammation of the carotid artery, leading to thickening of the carotid wall and unilateral carotidynia. This case report presents a 48-year-old woman who was diagnosed with TIPIC syndrome in a rheumatology outpatient clinic. The patient experienced right neck pain and numbness in the right hand, accompanied by local tenderness and increased arterial pulse. Laboratory tests showed no abnormalities, and imaging studies revealed inflammatory processes in the carotid artery. TIPIC syndrome is a self-limiting condition with a good prognosis and can be treated with nonsteroidal anti-inflammatory drugs. It is important for healthcare providers to be aware of this syndrome to prevent unnecessary treatment and to differentiate it from systemic vasculitis. [Extracted from the article]

Takayasu arteritis (TAK) is the main type of large vessel arteritis in young adults, which mainly affects the aorta and its main branches, leading to clinical manifestations such as syncope, intermittent limb claudication, hypertension, and abdominal pain. Among them, venous involvement is rarely reported. Here we show a case of TAK presenting as phlebitis. This was a 27‐year‐old woman, who initially admitted to our hospital with myalgia of the upper and lower extremities and night sweats. She was diagnosed as TAK according to the 1990 American College of Rheumatology TAK criteria. Surprisingly, vascular ultrasonography revealed wall thickening as indicated by macaroni sign of the multiple veins. TAK phlebitis appeared at the active phase, while disappearing rapidly at remission. Phlebitis might have a close relationship with disease activity. By retrospective study in our department, the estimated incidence rate of phlebitis might be 9.1% in TAK. With the literature review, it revealed that phlebitis might be an ignored manifestation in active TAK. However, due to the smaller sample size, it should be noted that a direct cause‐effect relationship cannot be established. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Transient perivascular inflammation of the carotid artery (TIPIC syndrome) is a rare, unclassified vascular syndrome that usually affects the distal part of the common carotid artery and has a favorable prognosis. The disease is often misdiagnosed even by neurologists due to the moderate intensity of clinical symptoms and their transient character. We present a case of a 52‐year‐old man who experienced two episodes of transient neck pain and moderate local tenderness one and a half years apart. Different imaging modalities, such as ultrasound, CT angiography, and high‐resolution 3T MR, were applied to better visualize the perivascular inflammation of the common carotid arteries. Based on the clinical‐radiological characteristics of our case and applying the diagnostic criteria, we established the diagnosis of TIPIC syndrome. The patient was treated with nonsteroidal anti‐inflammatory drugs for few weeks, and reduction in perivascular changes was observed in both episodes. The case raises questions about the phases of the disease, its duration and the intervals between follow‐ups. Our article also increases the awareness of this rare clinical‐radiological entity and presents recent data from the literature. [ABSTRACT FROM AUTHOR]

Aims: Giant cell arteritis (GCA) is a systemic vasculitis affecting medium and large arteries in patients aged over 50 years. Involvement of temporal arteries (TA) can lead to complications such as blindness and stroke. While the diagnostic gold standard is temporal artery biopsy (TAB), comorbidities and age‐related changes can make interpretation of such specimens difficult. This study aims to establish a baseline of TA changes in subjects without GCA to facilitate the interpretation of TAB. Methods and results: Bilateral TA specimens were collected from 100 consecutive eligible postmortem examinations. Subjects were divided into four age groups and specimens semiquantitatively evaluated for eccentric intimal fibroplasia, disruption and calcification of the internal elastic lamina (IEL), medial attenuation and degree of lymphocytic inflammation of the peri‐adventitia, adventitia, media and intima. The individual scores of intimal fibroplasia, IEL disruption and medial attenuation were added to yield a 'combined score (CS)'. Seventy‐eight 78 decedents were included in the final analysis following exclusion of 22 individuals for either lack of clinical information or inability to collect TA tissue. A total of 128 temporal artery specimens (50 bilateral from individual decedents, 28 unilateral) were available for examination. Intimal proliferation, IEL loss, IEL calcification and CS increased with age in a statistically significant fashion. Comparison of the oldest age group with the others showed statistically significant differences, although this was not uniformly preserved in comparison between the three youngest groups. Conclusion: Senescent arterial changes and healed GCA exhibit histological similarity and such changes increase proportionally with age. The CS demonstrates significant association with age overall and represents a potential avenue for development to 'normalise' TA biopsies from older individuals. [ABSTRACT FROM AUTHOR]

Background: Dermal arteritis of the nasal philtrum (DANP) has been described in large‐breed dogs. Objectives: To characterise clinically distinct, discrete fissures of the dorsolateral nasal alae associated with severe bleeding in German shepherd dogs (GSDs). Animals: Fourteen privately owned GSDs with linear rostrolateral nasal alar fissures and a histopathological diagnosis of nasal vasculopathy. Materials and Methods: Retrospective analysis of medical records and histological slides. Results: Mean age of onset was 6 years. Before biopsy, episodic arteriolar bleeding was noted in 11 of the 14 (79%) dogs. Slide analysis revealed enlarged nasal arterioles with expanded vascular tunics and luminal stenosis beneath ulcers. Histopathological lesions consistent with mucocutaneous pyoderma and/or facial discoid lupus erythematosus were present in 5 of the 14 (36%) dogs. Enlarged arterioles stained blue with Alcian blue and Masson's trichrome stains, consistent with deposition of mucin and collagen, respectively. Immunohistochemical stains (neutrophil myeloperoxidase, IBA1, CD3) were performed. CD3 was negative for all dogs, whilst neutrophil myeloperoxidase and IBA1 occasionally demonstrated intramural neutrophils (3 of the 14 dogs, 21%) or histiocytes (1 of the 14 dogs, 7%) in altered vessels, respectively. All dogs underwent medical management and/or surgical excision. Treatments included tacrolimus, prednisone, ciclosporin‐modified, pentoxifylline, antimicrobials and doxycycline/niacinamide. No dogs were treated with antimicrobials alone. For seven dogs with long‐term follow‐up, treatment response was complete in five (71%) and partial in two (29%), with six of the seven (86%) receiving immunomodulatory treatments to maintain remission. Conclusion and Clinical Relevance: Nasal alar arteriopathy of GSDs shares histopathological changes with DANP. It has characteristic clinical and histopathological features and appears amenable to immunomodulation. [ABSTRACT FROM AUTHOR]

Background: Aspergillus spp. is an uncommon and life‐threatening cause of transplantrenal artery pseudoaneurysm after kidney transplantation. Case: We report the case of a 62‐year‐old woman who underwent kidney transplantation 10 months before and presented a 7‐cm asymptomatic transplant renal artery pseudoaneurysm. Transplanted kidney and pseudoaneurysm were surgically removed in emergency. Renal graft, urine, and pseudoaneurysm cultures grew Aspergillus flavus. She recovered after 12 months of antifungal therapy. Literature review: To date 14 cases of Aspergillus spp. renal arteritis after kidney transplantation have been published, including 50% Aspergillus flavus arteritis. Vast majority were diagnosed within 90 days after transplantation (73%). Despite allograft nephrectomy and antifungal therapy, mortality rate was high (33%). [ABSTRACT FROM AUTHOR]

Fungal graft arteritis following normothermic machine perfusion of neonatal en-bloc kidney: A case study Normothermic and hypothermic oxygenated perfusion for donation after circulatory death in kidney transplantation: do we pay higher risk of severe infection after transplantation? Data on allograft contamination and posttransplant infection attributed to NMP is limited.[[6], [8]] We report the first possible fungal contamination of kidney allograft on NMP, ensuing in an allograft loss following KT. [Extracted from the article]

Lymphocytic thrombophilic arteritis and livedoid vasculopathy may both present with livedo racemosa and ulceration. We present 6 cases with features of both conditions, raising the possibility that they are either closely linked or are part of a spectrum of the same condition. [ABSTRACT FROM AUTHOR]

Polyarteritis nodosa is an idiopathic necrotizing vasculitis that affects small to medium‐sized arteries. We describe a case of polyarteritis nodosa in a captive common wooly monkey (Lagothrix lagotricha) associated with transmural intestinal necrosis and secondary peritonitis. This condition must be considered for differential diagnosis of segmental arteritis in neotropical primates. [ABSTRACT FROM AUTHOR]

Summary: Equine herpesvirus type‐1 (EHV‐1) and equine arteritis virus (EAV) are infectious agents that cause serious health risks to horse populations and are disbursed worldwide, which can lead to significant financial losses. In addition to being responsible for abortion and neonatal death, these viruses are associated with respiratory illness. Although previous research and reviews have been written on these viruses, both viruses still affect horse populations around the world and the vaccines currently available are not completely protective, especially against EHV‐1 and equine herpes myeloencephalopathy (EHM). Moreover, EAV is considered a threat to the $102 billion equine industry in the United States. As a result, these viruses represent a huge threat to the horse industry and efforts geared towards preventing the outbreak of the disease are strongly encouraged. For this reason, updates about these viruses are necessary and require more and more discussion on the nature and characteristics of these viruses to know how to overcome them. Prevention and control of abortion and neonatal foal death caused by each of the two viruses depend on appropriate management strategies coupled with prophylactic vaccination. This review presents the latest detailed information on EHV‐1 and EAV from several aspects such as transmission, clinical signs, pathogenesis, latest developments on the treatment of the diseases, vaccination, and finally challenges and future perspectives. The information presented herein will be useful in understanding EHV‐1 and EAV and formulating policies that can help to limit the spread of these viruses within horse populations. [ABSTRACT FROM AUTHOR]

Background: The role of culturing the graft preservation fluid (PF) is controversial and its impact on graft arteritis development remains unclear. Methods: Systematic literature search retrieving observational studies comparing solid organ transplant (SOT) recipients with culture‐positive PF versus culture‐negative PF. The quality of included studies was independently assessed according to the ROBINS‐I tool for observational studies. Meta‐analysis was performed using Mantel‐Haenszel random‐effect models. Graft site arteritis within 180 days from transplant was selected as the primary outcome. Results: Twenty‐one observational studies (N = 2208 positive PF vs. 4458 negative) were included. Among positive PF, 857 (38.8%) were classified as high‐risk group pathogens and 1351 (61.2%) as low‐risk pathogens. Low‐risk and negative PF showed similar odds ratios. A significant higher risk of graft arteritis was found in SOT recipients with a PF yielding a high‐risk pathogen (odds ratio [OR] 18.43, 95% confidence interval [CI] 7.83–43.40) compared to low‐risk and negative PF, with low heterogeneity (I2 = 2.24%). Similar results were found considering separately high‐risk bacteria (OR 12.02, 95%CI 4.88‐29.60) and fungi (OR 71.00, 95%CI 28.07–179.56), with no heterogeneity (I2 = 0%), and in the subgroup analyses of the liver (OR 16.78, 95%CI 2.95–95.47) and kidney (OR 19.90, 95%CI 4.78–82.79) recipients. However, data about diagnostic features of graft arteritis were very limited, indeed for only 11 of the 93 events histological or microbiological results were reported. Conclusions: Our results may support the performance of PF culturing and a preemptive diagnostic or therapeutic management upon isolation of high‐risk pathogens. Further studies based on a reliable diagnosis of graft arteritis are needed. [ABSTRACT FROM AUTHOR]

We report a case of hyperimmunoglobulin (Ig) E syndrome (HIES) with a coronary artery aneurysm (CAA) in a 25‐year‐old Japanese man. He died suddenly due to chronic heart failure associated with HIES. We noted a CAA at the trunk of the left coronary artery and granulomatous and fibrinoid necrotizing arteritis of the middle portion of the left anterior descending during the autopsy. We speculate herein on the relationship between the aneurysm and arteritis. These findings facilitate a better understanding of the pathogenesis underlying HIES. [ABSTRACT FROM AUTHOR]

At 10 days follow-up, the patient revealed reduced intake of cannabis (2-3 cannabis-cigarettes/day), the RP was persistent; subungual hemorrhage with mild onycholysis was noticed. Cannabis arteritis is one of the rare complications of cannabis use. [Extracted from the article]

This article discusses a case of giant-cell arteritis (GCA) in a 78-year-old woman who presented with a low-grade fever of unknown origin. The patient initially visited a dental clinic for toothache and jaw claudication, but no dental issues were found. The patient was then referred to a clinic where a slightly enlarged left temporal artery without pulsation and tenderness was observed. Ultrasonography revealed thickened walls in the temporal artery frontal branches, confirming the diagnosis of GCA. Prompt diagnosis and treatment with prednisolone led to the resolution of symptoms. The article emphasizes the importance of considering GCA in elderly Asian patients with fever and temple pain and highlights the usefulness of ultrasonography for diagnosis. [Extracted from the article]

Introduction. Cerebral vascular comorbidities may occur in patients with schistosomiasis, as described in case reports. Aim and Methods. We have summarized general clinical and neurological features in patients with stroke associated with schistosomiasis, through a review of case reports in the literature. Investigation Outcomes. A total of eight case reports were retrieved. The mean age of patients was 36.42 ± 16.7 (19 to 56 years), four females, three males, and one anonymous sex. Eosinophilia was the most frequent feature at presentation, followed by cardiac abnormalities, confusion, fever, ataxia, hemiplegia, headache, urticaria, dysphasia, and memory impairment. Patients usually present with watershed infarction or intracranial vasculitis. In one case, extracranial carotid arteries presented with inflammation and stenosis. The patient's serology was positive on admission in five cases. Full neurological recovery was reported in three cases, and partial improvement in another three. In two cases, information on neurological outcomes was incomplete. Stroke in schistosomiasis can be caused by haemodynamic impairment, direct lesion to the arterial wall, vasa vasorum obliterative endarteritis, contiguity with a focus of inflamed tissue, or inflammatory intimal damage. Schistosomiasis needs to be included in the differential diagnosis of stroke in people living or coming back from endemic areas. Conclusions. Further studies addressing the noncommunicable comorbidity issues related to this condition are needed. [ABSTRACT FROM AUTHOR]

Takayasu arteritis is a rare disease mostly found in Asian populations. Cases have been reported in patients with inflammatory bowel disease, suggesting possible genetic linkage. The objective of this clinical case report is to highlight a rare finding of arteritis signs and symptoms in a 32-year-old Caucasian woman (likely early that it did not yet meet classification for official diagnosis as Takayasu arteritis) who subsequently was diagnosed with ulcerative colitis a few months later. The patient presented to the hospital with throbbing neck pain and tenderness around the area of her right carotid artery distribution, nonspecific visual changes, and bilateral upper extremity paresthesia, with significant findings of 50-69% right carotid artery stenosis on a recent outpatient carotid Doppler ultrasound. Based on additional laboratory, clinical, and advanced imaging findings at the hospital, a diagnosis of arteritis not yet classifiable as Takayasu arteritis was made, and the patient was treated with corticosteroids. Unfortunately, she developed bradycardia that was later attributed to the corticosteroid regimen and the medication was discontinued. By follow-up in the clinic, the patient's carotidynia improved, but now, she reported a three-month history of bloody stools. Colonoscopy and pathology findings were consistent with ulcerative colitis, and the patient was started on mesalamine. The association of inflammatory bowel disease and Takayasu arteritis should not be overlooked, as future treatment methods and early, continuous surveillance may be critical in improving quality of life and avoiding serious complications. [ABSTRACT FROM AUTHOR]

Objective: Evidence‐based studies on endovascular approaches for childhood Takayasu arteritis (TAK) are limited. Our objective was to present the largest current real‐world scenario for patients with childhood TAK undergoing interventions and their postinterventional outcomes. Methods: Data were collected for patients with childhood TAK admitted from 2002 to 2017. Complication/reintervention‐free survival was projected by Kaplan‐Meier methods. Associated factors for intervention and predictors for postinterventional complications/reinterventions were assessed via regression models. Results: Among 101 patients enrolled, 69 (68.3%) underwent 121 interventions (angioplasty 95, stenting 26) during a 3.1‐year follow‐up. Compared with the nonintervention group, the intervention group independently associated with a male population (odds ratio [OR] 0.27, P = 0.035) and type IV disease (OR 17.92, P = 0.001). Male sex also marginally indicated a risk for reintervention (hazard ratio [HR] 3.22, P = 0.05). Baseline retinopathy, delay in diagnosis, and descending thoracic aorta involvement were associated with stent insertion (P < 0.05). Hypertension secondary to renal artery stenosis (RAS; 59.4%) or mid‐aorta stenosis (MAS; 14.5%), heart failure (21.7%), and claudication (21.7%) were leading clinical hints for interventions. The technical success rate was 96.7%. During a median 2.88‐year of follow‐up after intervention, 36 lesions occurred with complications in 28 patients, and 22 lesions in 17 patients, particularly on the renal artery or mid‐aorta. The 5‐year complication‐free and reintervention‐free survivals were 50.7% and 65.8%, respectively. Peri‐interventional dual antiplatelet therapy (DAPT; HR 0.31), concurrent surgery (HR 26.5), and technical failure (HR 3.65) were independent predictors for complications (P < 0.05). Male sex (HR 2.52), retinopathy secondary to hypertension (HR 3.41), and pulmonary artery hypertension (PAH; HR 3.64) were baseline indicators for complications (P < 0.05). Conclusion: Over two‐thirds of patients with childhood TAK require interventions, and the 5‐year complication‐free survival is 50.7%. Male sex, retinopathy, and PAH at baseline indicate the possibility of unfavorable outcomes. Interventions on MAS or RAS in childhood TAK raise specific concerns. DAPT peri‐intervention appears to protect patients with childhood TAK from postinterventional complications. [ABSTRACT FROM AUTHOR]

Objective: To provide evidence-based recommendations and expert guidance for the management of systemic polyarteritis nodosa (PAN).Methods: Twenty-one clinical questions regarding diagnostic testing, treatment, and management were developed in the population, intervention, comparator, and outcome (PICO) format for systemic, non-hepatitis B-related PAN. Systematic literature reviews were conducted for each PICO question. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to assess the quality of evidence and formulate recommendations. Each recommendation required ≥70% consensus among the Voting Panel.Results: We present 16 recommendations and 1 ungraded position statement for PAN. Most recommendations were graded as conditional due to the paucity of evidence. These recommendations support early treatment of severe PAN with cyclophosphamide and glucocorticoids, limiting toxicity through minimizing long-term exposure to both treatments, and the use of imaging and tissue biopsy for disease diagnosis. These recommendations endorse minimizing risk to the patient by using established therapy at disease onset and identify new areas where adjunctive therapy may be warranted.Conclusion: These recommendations provide guidance regarding diagnostic strategies, use of pharmacologic agents, and imaging for patients with PAN. [ABSTRACT FROM AUTHOR]

Objective: To provide evidence-based recommendations and expert guidance for the management of giant cell arteritis (GCA) and Takayasu arteritis (TAK) as exemplars of large vessel vasculitis.Methods: Clinical questions regarding diagnostic testing, treatment, and management were developed in the population, intervention, comparator, and outcome (PICO) format for GCA and TAK (27 for GCA, 27 for TAK). Systematic literature reviews were conducted for each PICO question. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to rate the quality of the evidence. Recommendations were developed by the Voting Panel, comprising adult and pediatric rheumatologists and patients. Each recommendation required ≥70% consensus among the Voting Panel.Results: We present 22 recommendations and 2 ungraded position statements for GCA, and 20 recommendations and 1 ungraded position statement for TAK. These recommendations and statements address clinical questions relating to the use of diagnostic testing, including imaging, treatments, and surgical interventions in GCA and TAK. Recommendations for GCA include support for the use of glucocorticoid-sparing immunosuppressive agents and the use of imaging to identify large vessel involvement. Recommendations for TAK include the use of nonglucocorticoid immunosuppressive agents with glucocorticoids as initial therapy. There were only 2 strong recommendations; the remaining recommendations were conditional due to the low quality of evidence available for most PICO questions.Conclusion: These recommendations provide guidance regarding the evaluation and management of patients with GCA and TAK, including diagnostic strategies, use of pharmacologic agents, and surgical interventions. [ABSTRACT FROM AUTHOR]

If the development of vasculitis after mRNA COVID-19 vaccination is mediated by an anti-SARS-CoV-2 antibody, what could be an antigen for the antibody? Instead of responding to a SARS-CoV-2 spike protein, an anti-SARS-CoV-2 spike protein antibody could react to a human tissue antigen with homology to the SARS-CoV-2 spike protein before developing post-COVID-19 vaccination vasculitis.10 However, it has not been demonstrated whether such an antibody causes post-COVID-19 vaccination vasculitis. Dear Editor, Cutaneous adverse reactions after the administration of coronavirus disease 2019 (COVID-19) vaccine have been reported.1 However, cutaneous vasculitis has only been described in a few cases. [Extracted from the article]

Lymphocytic thrombophilic arteritis and Sneddon syndrome can have very similar clinical presentations with chronic persistent widespread blanchable livedo racemosa. Lymphocytic thrombophilic arteritis has only recently been described and generally is associated with a benign prognosis. Sneddon syndrome is associated with the development of multiple cerebrovascular accidents and progressive neurological impairment. We present three cases of Sneddon syndrome and compare them with lymphocytic thrombophilic arteritis to identify patients at risk of neurological events. [ABSTRACT FROM AUTHOR]

Giant cell arteritis is a medical emergency because of the high risk of irreversible blindness and cerebrovascular accidents. While elevated inflammatory markers, temporal artery biopsy and modern imaging modalities are useful diagnostic aids, thorough history taking and clinical acumen still remain key elements in establishing a timely diagnosis. Glucocorticoids are the cornerstone of treatment but are associated with high relapse rates and side effects. Targeted biologic agents may open up new treatment approaches in the future. [ABSTRACT FROM AUTHOR]

Objective: To investigate the association between specimen length and number of sections evaluated and the diagnostic yield of temporal artery biopsy (TAB) for giant cell arteritis (GCA).Methods: A pathologist reviewed all TABs performed for suspected GCA between January 1991 and December 2012. The blocks of all the inadequate and negative biopsy specimens were recut, and further slides at deeper levels were stained with hematoxylin and eosin in order to avoid missing inflammatory changes.Results: In total, findings from 662 TABs were included in the study (71% female; mean age 73.2 years). A total of 427 TAB specimens (65%) were classified as negative, and 235 (35%) were classified as positive for GCA. Compared to those with negative TAB results, patients with positive TAB results were older and more frequently female. There was no difference in postfixation TAB specimen length between TAB specimens negative and positive for GCA (mean 6.5 mm versus 6.9 mm; P = 0.068). Cuts of additional biopsy sections revealed inflammation at deeper levels in 26 of 408 TAB specimens (6.4%) originally reported as uninflamed. The inflamed section was the second in 14 TAB specimens, the third in 9 specimens, and the fourth in 3 specimens. Piecewise logistic regression identified 5 mm as the TAB specimen length change point for diagnostic sensitivity. Compared to a TAB specimen length of <5 mm, the age- and sex-adjusted odds ratio for positive TAB results in samples ≥5 mm long was 1.5 (95% confidence interval 1.0-2.0), P = 0.032.Conclusion: A postfixation TAB specimen length of at least 5 mm should be sufficient to make a histologic diagnosis of GCA. In order not to miss inflammatory changes, at least 3 further sections at deeper levels should be evaluated in all negative TAB specimens. [ABSTRACT FROM AUTHOR]

Cough is not a widely recognised symptom of large vessel vasculitides. If not promptly diagnosed and treated, large vessel vasculitis can have serious clinical consequences. We present the case of a 76‐year‐old man who presented with a subacute history of persistent dry cough, was found to have extensive aortitis on imaging, and experienced rapid resolution of symptoms with immunosuppression. [ABSTRACT FROM AUTHOR]

Summary: Equine viral arteritis (EVA) is a notifiable disease in the UK with potentially serious consequences for horse owners and breeders. Legislation exists under 'The Equine Viral Arteritis Order 1995' to protect the UK from this contagious equine disease. The UK is at risk of introduction of EVA through importation of infected horses or semen. There is however much misunderstanding regarding the importance of EVA and occasionally misinterpretation, specifically on how to protect and manage stallions with vaccination. Issues with changing vaccine datasheet recommendations and vaccine availability have resulted in stallions being inappropriately vaccinated or vaccinations lapsing. This article is aimed at the practicing veterinary surgeon, to update them as to the current status of EVA vaccination and disease screening in horses in the UK and how to avoid some common pitfalls. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a complex and long‐lasting disorder characterized by chronic inflammation of arteries that leads to the initiation and progression of lipid‐rich plaques, in which monocytes/macrophages play the central role in endothelial inflammation and taking up these lipids. Circulating monocytes can adopt a long‐term proinflammatory phenotype leading to their atherogenic activities. During atherogenic condition, inflammatory monocytes adhere to the surface of the activated endothelial cells and then transmigrate across the endothelial monolayer into the intima, where they proliferate and differentiate into macrophages and take up the lipoproteins, forming foam cells that derive atherosclerosis progression. Therefore, modulating the atherogenic activities of inflammatory monocytes can provide a valuable therapeutic approach for atherosclerosis prevention and treatment. Curcumin is a naturally occurring polyphenolic compound with numerous pharmacological activities and shows protective effects against atherosclerosis; however, underlying mechanisms are not clearly known yet. In the present review, on the basis of a growing body of evidence, we show that curcumin can exert antiatherosclerotic effect through inhibiting the atherogenic properties of monocytes, including inflammatory cytokine production, adhesion, and transendothelial migration, as well as intracellular cholesterol accumulation. [ABSTRACT FROM AUTHOR]

GLO:EUZ/01feb20:jfd13099-fig-0003.jpg PHOTO (COLOR): Colonies of Fusarium solani isolated in pure culture on Sabouraud dextrose agar from the arterial lesion in Hippocampus erectus [Colour figure can be viewed at wileyonlinelibrary.com] gl I Fusarium solani i has previously been described in lined seahorses at the Georgia Aquarium (Salter et al., [16]), where 100% mortality of the population was observed and antifungal treatment was ineffective. Diseases of captive yellow seahorse Hippocampus kuda Bleeker, pot-bellied seahorse Hippocampus abdominalis Lesson and weedy seadragon Phyllopteryx taeniolatus (Lacepede). Dermatitis and systemic mycosis in lined seahorses Hippocampus erectus associated with a marine-adapted Fusarium solani species complex pathogen. [Extracted from the article]

Checkpoint inhibition has become an important target in the management of malignant melanoma. As anti‐CTLA4 inhibitors and anti‐PD1 antibodies are increasingly utilized, reports of immune‐related adverse events (IRAEs) are becoming more frequent. Common noted cutaneous IRAEs are morbilliform, lichenoid, bullous, granulomatous, psoriasiform, and eczematous eruptions. We report a case of interstitial granulomatous dermatitis and granulomatous arteritis in the setting of nivolumab (anti‐PD1) monotherapy for metastatic melanoma. There are many different causes for granulomatous vasculitis, such as herpes virus infection, lymphoproliferative disorders, systemic vasculitis, and inflammatory bowel disease. This report adds to the growing literature on granulomatous IRAEs due to checkpoint inhibition. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease (KD) is a systemic inflammatory disease resulting in an acute febrile syndrome commonly affecting children younger than 5 years. Coronary arteritis in KD is occasionally non‐responsive to several treatments. Recently, adipose tissue‐derived stem cells (ADSCs) have been shown to have anti‐inflammatory, immunosuppressive, and tissue‐repair characteristics and are considered a useful treatment for inflammatory disease. The present study aimed to elucidate whether the administration of ADSCs can suppress KD‐associated vasculitis in vivo. Methods: Candida albicans water‐soluble fraction is often used to model KD via the induction of severe coronary arteritis. Kawasaki disease model mice were intravenously administered ADSCs and phosphate‐buffered saline (PBS). On day 29, the mice were sacrificed and hearts from mice in each group were dissected. This was followed by serum collection. Cardiac tissue sections were subjected to histopathological examination to evaluate the inflammatory area. The levels of pro‐inflammatory cytokines in the serum were analyzed at days 15 and 29. The survival rates of both groups were compared. Results: The mean inflammatory area in coronary arteritis was significantly lower in the ADSC group compared to the PBS group (P < 0.01). Furthermore, the levels of pro‐inflammatory cytokines, such as IL‐1β, IL‐12, IL‐17, RANTES, INF‐γ, and TNF‐α, in the ADSC group were significantly lower than those in the PBS group. Moreover, the ADSC group had a significantly higher survival rate than the PBS group. Conclusions: These findings highlight that ADSCs have anti‐inflammatory and immune regulatory functions that could provide novel cell‐based therapeutic strategies for severe KD. [ABSTRACT FROM AUTHOR]

A case of neuro-Behcet's disease preceded by cellulitis-like cutaneous arteritis and multiple pharyngeal ulcers Behcet's disease (BD) is a multisystem relapsing inflammatory disorder of unknown cause. The Chapel Hills Consensus Conference 2012 classified BD vasculitis as variable vessel vasculitis, and its lesions are distributed in the arteriovenous vessels, regardless of vessel size.[3] Arterial lesions are rare in BD. [Extracted from the article]

Coarctation of aorta(CoA), complicated by endarteritis in a children is very rare. Here we present a case of endarteritis in an unoperated CoA in a four year old boy. CoA had been diagnosed in the referring hospital, yet the diagnosis of endocarditis distal to CoA, was made in the tertiary center using modified transthoracic echo windows or focused views. After six weeks of intravenous antibiotic treatment, a coarctectomy and end‐to‐end anastomosis was performed and he recovered clinically well. This case report concludes that echocardiography remains as the standard diagnostic method for identifying intracardiac manifestations of infective endocarditis/endarteritis. Last but foremost, it delineates the importance of modified transthoracic echo windows or focused views in identifying the unusual position of endocarditis. [ABSTRACT FROM AUTHOR]

Fungal endocarditis is a relatively rare occurrence with high morbidity and mortality. Patients may have an indolent and non‐specific course requiring a high index of suspicion to make a diagnosis. Here, we present the case of a 33‐year‐old patient who presented with fevers and acute lower limb ischemia requiring a 4‐compartment fasciotomy caused by septic emboli from Candida albicans endocarditis. The patient had a large vegetation in the ascending aorta associated with a mycotic aneurysm, which is an exceedingly rare location for a vegetation. We also review the literature and summarize the typical echocardiographic appearance and vegetation locations in fungal endocarditis. [ABSTRACT FROM AUTHOR]

Giant-cell arteritis (GCA), also referred to as temporal arteritis, is the most common primary vasculitis of the elderly involving the extracranial branches of the carotid arteries, in particular, the temporal artery. Patients usually present with temporal headaches, visual impairment, fever, and scalp tenderness. Scalp necrosis associated with GCA is a rare occurrence with approximately 100 cases reported in the literature to date. It is a therapeutic emergency requiring urgent management as it may lead to irreversible loss of vision. To increase awareness of this severe complication, we report a patient with a scalp necrosis revealing a GCA. [ABSTRACT FROM AUTHOR]

Eosinophilic aortitis is a rare condition in animals and humans, and it has been occasionally reported associated with parasitic migration and with a poorly understood complex group of autoimmune vasculitides. Here, we describe a case of eosinophilic aortitis with thoracic aortic aneurysm and rupture in a captive‐born owl monkey and discuss the differential diagnoses. [ABSTRACT FROM AUTHOR]

Key Clinical Message: When fibrosis develops in Takayasu arteritis (TA), endovascular treatment may become necessary. A 63‐year‐old woman with TA underwent PTA with a nitinol‐structured (chocolate‐like) drug‐coated balloon (C‐DEB PTA). She remained in remission for >1 year. The case may foster research into the use of C‐DEB PTA in TA. When fibrosis develops in Takayasu arteritis (TA), endovascular treatment may become necessary. A 63‐year‐old woman with TA underwent PTA with a nitinol‐structured (chocolate‐like) drug‐coated balloon (C‐DEB PTA). She remained in remission for >1 year. The case may foster research into the use of C‐DEB PTA in TA. [ABSTRACT FROM AUTHOR]

Summary: Equine arteritis virus is the causative agent of equine viral arteritis, a respiratory and reproductive disease that affects the members of the family Equidae. The virus was first isolated from the lung of an aborted fetus after an extensive outbreak of respiratory disease and abortion on a Standardbred breeding farm near Bucyrus, Ohio, in 1953. Since then, periodic outbreaks of equine viral arteritis have been reported in a number of countries around the world. This disease may result in significant economic loss to the equine industry due to the occurrence of abortion in pregnant mares, neonatal mortality, and establishment of the carrier state in stallions. This article provides an extensive review on equine arteritis virus, epidemiology, disease, pathogenesis, and prevention and control measures. [ABSTRACT FROM AUTHOR]

Summary: Objective: The aim of this study was to evaluate an extended protocol of the large vessels using high‐frequency duplex ultrasound (DUS) for detection of vessel wall inflammation. Methods: Fifty‐eight patients performed a DUS examination where arteritis could not be excluded. All DUS examinations were performed using ACUSON S2000 TM ultrasound system (Siemens Medical Solutions USA, Inc.). High‐frequency linear transducers were used (18L6 MHz, 9L4MHz) or curve linear for the aortic arch (6C2 MHz). Carotid, vertebral, central neck arteries (subclavian, axillary, innominate) arteries, aortic arch and femoral arteries were studied. Circumferential, homogenous wall thickening, with or without a hyperechogenic stripe lining the innermost layer, were regarded as typical signs of arteritis. Intima‐media thickness (IMT) was measured in the patients and a normal control group. The latest clinical updated diagnosis was assessed at least 6 months after DUS. Results: The DUS findings showed normal vessels (n = 14), arteritis and atherosclerosis (n = 13), atherosclerosis (n = 15) and arteritis (n = 16). The latter group had a significant increased IMT in the common femoral artery and the common carotid artery (mean 1·0 ±  SD 0·3 mm versus 0·6 ± 0·2 mm in the normal group (n = 37), P<0·00001, 1·2 ± 0·5 mm versus 0·8 ± 0·2 mm in the normal group (n = 40), P<0·00001). In the groups with sonographic signs implying arteritis (n = 29), 20 patients had a clinical diagnosis of arteritis, whereas eight patients had another main diagnosis such as malignancy/other inflammatory or infectious disease complicated by inflammation of the vessel wall. One patient had multiple diagnoses and was not possible to classify. Conclusion: An extended ultrasound protocol for central neck and leg arteries could be of value for diagnosis of arteritis. In case of atypical vessel wall inflammation, other main diagnoses should be considered. [ABSTRACT FROM AUTHOR]

Abstract: We describe three patients who presented with a striking erythematous non‐blanching annular eruption and features of lymphocytic thrombophilic arteritis (LTA), with a prominent lymphocytic vasculitis involving deep dermal vessels. Lymphocytic inflammation was also evident in the superficial vessels and one patient had small superficial ulcers over the ankle area resembling livedoid vasculopathy (LV). Multiple biopsies demonstrated a persistent absence of neutrophils in the infiltrate consistent with a lymphocytic process. In addition to highlighting the annular morphology as a novel presentation of LTA, these cases suggest a possible relationship between LV and LTA and support the notion that they are distinct from neutrophilic vasculitides such as cutaneous polyarteritis nodosa. [ABSTRACT FROM AUTHOR]

Abstract: Background: Temporal artery biopsy is considered the investigation of choice to diagnose definitively giant cell arteritis (GCA) in patients with compatible symptoms. However it is invasive and not completely sensitive. Serum markers, particularly erythrocyte sedimentation rate (ESR), can be supportive, but are not definitive in individual cases. Aims: To investigate whether indices derived from the full blood count, including neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) were associated with a positive biopsy in patients with suspected GCA. Methods: The clinical and pathological details of 537 patients undergoing temporal artery biopsy at our institution from 1992 to 2015 were reviewed. Results: In univariate analysis high platelets (odds ratio (OR) 4.44, P < 0.001), NLR (OR 1.81, P = 0.02), PLR (OR 3.25, P < 0.001), C‐reactive protein (CRP) (OR 3.00, P < 0.001), ESR (OR 3.62, P < 0.001) and increased age (OR 1.03, P = 0.006) were strongly associated with a positive biopsy. In multivariate modelling only high platelets (P < 0.001) and ESR (P = 0.049) maintained significance. Conclusions: We conclude that the presence of thrombocytosis and high NLR, PLR, ESR and CRP can all be used clinically to support the diagnosis of GCA prior to biopsy. Of particular note, in multivariate modelling the presence of thrombocytosis is a stronger predictor of a positive temporal artery biopsy than ESR. Therefore, careful consideration of the findings in a full blood count can be used to predict the likelihood of a positive temporal artery biopsy in patients with suspected GCA. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To describe the features of exceptional coexisting Takayasu arteritis (TA) and sarcoidosis, two conditions of unknown cause associated with a common immunologic pattern. Methods: We report seven cases of concomitant sarcoidosis‐Takayasu or Takayasu‐like vasculitis, observed in two referral centers between 1995 and 2015. Results: All patients were female. The mean age at sarcoidosis diagnosis and TA diagnosis was 36 and 37 years, respectively. Sarcoidosis occurred in 86% of cases before or together with TA. Sarcoidosis always had a classic expression except for one renal localization. Sarcoidosis was not severe and mostly non‐treated (86%). In all cases of TA, supra‐aortic arteries were involved; in only two TA cases a more diffuse inflammatory arterial involvement was noted. In one case, Takayasu arteritis occurred despite immunosuppressive therapy given for sarcoidosis. All patients received for TA a treatment with corticosteroids associated with methotrexate (four cases), infliximab (one case) or tocilizumab (one case). After a mean follow‐up of 89 months, TA always improved and no death was observed. Conclusions: TA stands as pathology associated with sarcoidosis. TA occurred in three cases among 50. When sarcoidosis preceded TA, a recovery of sarcoidosis was achieved mostly without treatment. TA is a prognostic and therapeutic factor. Immunosuppressive treatment, including steroids, led to a good prognosis for TA as well as for sarcoidosis. [ABSTRACT FROM AUTHOR]

Objective In addition to traditional risk factors, excess cardiovascular disease ( CVD) in rheumatoid arthritis ( RA) is attributed to enhanced vascular and/or systemic inflammation. In several small studies using 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F- FDG- PET/ CT) to directly assess vascular inflammation, FDG uptake was higher in RA patients than in controls. Using a substantially larger sample of RA patients, we sought to identify RA disease characteristics independently associated with vascular FDG uptake. Methods RA patients underwent cardiac FDG- PET/ CT, with aortic inflammation assessed by quantification of FDG uptake in the ascending aorta, calculated as the mean and maximum (max) standardized uptake value ( SUV) of the entire ascending aorta and of its most diseased segment ( SUV MDS). Univariate and multivariable regression models were constructed to model the associations of patient characteristics with aortic FDG uptake. Results Ninety-one RA patients were scanned. In multivariable models, in addition to the independent associations of hypertension and body mass index with increased aortic FDG uptake, the prevalence of rheumatoid nodules correlated with the SUV mean and SUV MDS mean measures, while anti-cyclic citrullinated peptide (anti- CCP) antibodies correlated inversely with these measures and with the SUV max and SUV MDS max ( P < 0.05). A significant association of RA disease activity with aortic FDG uptake was observed but was restricted to anti- CCP seropositivity. Conclusion Traditional CV risk factors and RA disease characteristics (rheumatoid nodules and the Disease Activity Score in 28 joints using the C-reactive protein level in anti- CCP antibody-positive individuals) were independently associated with ascending aortic FDG uptake in RA patients without clinical CVD. [ABSTRACT FROM AUTHOR]

Fungal arteritis affecting graft arteries is a rare but life-threatening complication in kidney transplantation ( KT). Here, we report the case of a patient with Aspergillus arteritis who experienced renal artery rupture 8 days after KT. We also reviewed 50 other reported cases of fungal arteritis after KT. We found that fungal contamination can occur during kidney graft harvest, preservation, and/or transplantation. Typically, early diagnosis, timely antifungal treatment, and emergency surgery seem crucial for avoiding life-threatening vascular complications. [ABSTRACT FROM AUTHOR]

A novel equine arteritis virus ( EAV) was isolated and sequenced from feral donkeys in Chile. Phylogenetic analysis indicates that the new virus and South African asinine strains diverged at least 100 years from equine EAV strains. The results indicate that asinine strains belonged to a different EAV genotype. [ABSTRACT FROM AUTHOR]