phenylephrine-hydrochloride and Giant-Cell-Arteritis

To summarize recent evidence regarding the presence and potential role of the microbiome in systemic vasculitides.. Microbiomic descriptions are now available in patients with small, medium and large vessel vasculitis. The majority of studies have evaluated gastrointestinal inhabitants, with a smaller number of studies describing the nasal, pulmonary or vascular microbiomes. Most published studies are observational and cross-sectional. Dysbiosis is seen frequently in vasculitis patients with reduced microbial diversity observed in nasal, fecal and vascular samples compared with disease and/or healthy controls. Predominant bacteria vary, but overall, patients with vasculitis tend to have more pathogenic and less commensal bacteria in active disease. In the few longitudinal studies available, improvement or resolution of dysbiosis has been observed following vasculitis treatment and improved disease activity.. Dysbiosis and reduced microbial diversity has been identified in patients with small, medium and large vessel vasculitis. Although limited data suggests microbiomes may 'normalize' following immunosuppression, cause or effect cannot be determined. It is hypothesized that microbial disruption in a genetically susceptible individual may trigger excessive host immune activation and vasculitis; however, larger studies with longitudinal and translational design are needed to further our current understanding.

Topics: Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis; Bacteria; Cross-Sectional Studies; Dysbiosis; Feces; Giant Cell Arteritis; Humans; Longitudinal Studies; Microbiota; Nose; Symbiosis; Systemic Vasculitis; Vasculitis

Topics: Aged, 80 and over; Anti-Inflammatory Agents; Giant Cell Arteritis; Humans; Male; Methylprednisolone; Necrosis; Nose; Prednisone; Rhinoplasty; Thrombosis

Topics: Acyclovir; Administration, Oral; Aged; Aged, 80 and over; Antiviral Agents; Conjunctivitis, Viral; Diagnosis, Differential; Female; Giant Cell Arteritis; Herpes Zoster Ophthalmicus; Herpesvirus 3, Human; Humans; Nose; Polymerase Chain Reaction

Wegener's granulomatosis and forms of giant cell arteritis result from vasculitis and masquerade with symptoms of common head and neck disease entities. Recognition of the manifestations of vasculitis can be made early in the disease course and confirmed pathologically, allowing effective therapy. Current therapy of Wegener's granulomatosis with Cytoxin and Imuran and steroids for giant cell arteritis frequently results in reversal of head and neck involvement, prevention of systemic disease, and prolonged survival.

Topics: Aortic Arch Syndromes; Diagnosis, Differential; Eye; Female; Giant Cell Arteritis; Granulomatosis with Polyangiitis; Head; Humans; Middle Aged; Mouth Mucosa; Neck; Nose; Paranasal Sinuses; Takayasu Arteritis