Neurology

Vasculitis

Questions discussed in this category

How would you approach the workup and management of a young patient with recurrent biannual non-scarring oral ulcers and new onset neurologic symptoms with associated CNS white matter lesions concerning for Behcet’s?

1 Answer available

When is brain biopsy useful/warranted as part of the diagnostic work-up in patients with suspected primary CNS angiitis?

3 Answers available

Do you typically screen every patient with headaches after the age of 60 with ESR?

6 Answers available

How would you interpret a temporal artery biopsy demonstrating focal chronic inflammation in the adventitia associated with small adventitial vessels and nerves without inflammation of the intima and media and without giant cells?

2 Answers available

How would you approach additional workup and management of a patient with active Crohn’s disease, who has multiple lung and brain nodules, with lung pathology demonstrating necrotizing granulomatous inflammation and brain biopsy with granulomatous inflammation and medium-large vessel vasculitis?

The patient is on mesalamine for Crohn’s and CellCept and HCQ for skin manifestations (currently on hold during workup). The infectious workup i...

1 Answer available

Do you routinely obtain baseline vascular imaging (CTA, MRA, PET) in patients with suspected GCA, but negative temporal artery biopsy?

Per 2021 GCA Vasculitis Guidelines: low evidence, but conditional recommendation for CTA neck, chest, abd/pelvis. Is anybody following this or do you ...

2 Answers available

Is IL-6 inhibition an option in patients who are going to be rechallenged with checkpoint inhibitors after previously developing ICI-mediated temporal arteritis?

Would the checkpoint inhibitor still work if blocking only that portion of the inflammatory cascade as opposed to more global blockade with steroids?

2 Answers available

How would you approach the treatment of checkpoint-inhibitor-mediated temporal arteritis?

Is there role for IVIG? Would you alter the dose or time course of steroid therapy?

2 Answers available

Can giant cell arteritis present with a partial cranial neuropathy?

3 Answers available

Do you always perform temporal artery biopsy in patients with positive inflammatory markers and high clinical suspicion of GCA?

2 Answers available

Is either ESR or CRP more sensitive or specific for the diagnosis of GCA?

Additionally, what is the current role for temporal artery ultrasound in workup for GCA?

3 Answers available

What is the utility in repeating a temporal ultrasound (US) in a previously US diagnosed positive GCA patient who has received treatment and is presenting with recurrent GCA symptoms?

1 Answer available

What is your steroid-sparing agent of choice to treat GCA given the current tocilizumab shortage?

Thoughts on sarilumab vs methotrexate, or just treat with steroids alone

1 Answer available

What is your approach to checking serum vWF antigen levels in adult patients with CNS vasculitis for monitoring disease activity?

Small study in pediatric PACNS have evaluated this as a potential marker (Cellucci et al., PMID 22740622)

1 Answer available

What is your approach for treating mononeuritis multiplex in patients with ANCA vasculitis?

Specifically, do you reach for Rituximab or cyclophosphamide?

1 Answer available

Are there features of a nerve biopsy that help distinguish late nerve damage from vasculitis versus from a demyelinating disease?

1 Answer available

Do you treat HIV/AIDS-associated CNS vasculitis with antiretrovirals alone or in combination with steroids?

1 Answer available

How do you monitor response to treatment in patients with mononeuritis multiplex secondary to vasculitis?

Given the slow recovery of nerve damage, what would you expect to see on a repeat EMG after treatment? Continued denervation or just sequelae of past ...

1 Answer available