%0 Journal Article
%T Outcome and prognosis of isolated carotid vasculitis.
%A Hankard A
%A Maalouf G
%A Laouni J
%A Espitia O
%A Agard C
%A De Boysson H
%A Aouba A
%A Sacré K
%A Papo T
%A Leroux G
%A Vautier M
%A Desbois AC
%A Domont F
%A Le Joncour A
%A Mirouse A
%A Chiche L
%A Skaff Y
%A Gaudric J
%A Boussouar S
%A Redheuil A
%A Bravetti M
%A Cacoub P
%A Saadoun D
%J J Autoimmun
%V 146
%N 0
%D 2024 Jun 17
%M 38761452
%F 14.511
%R 10.1016/j.jaut.2024.103242
%X OBJECTIVE: To assess the prognosis and outcome of patients with isolated carotid vasculitis.
METHODS: We performed a retrospective multicenter study of 36 patients (median age at diagnosis was 37 [IQR 27-45] years and 11 [31 %] patients were men) with initial presentation as isolated carotid vasculitis. Study endpoints included vascular complications, relapses, and progression to large vessel vasculitis (i.e. Giant cell arteritis or Takayasu).
RESULTS: The most frequent involvement was the left internal carotid artery (39 %), and 81 % had stenosis. After a median follow-up of 32 months [IQR 12-96], 21 (58 %) patients had a vascular event, including 31 % of new onset vascular lesions and 25 % of stroke/transient ischemic attack. Patients with stroke had less carotidynia at diagnosis (33 % vs 74 %, p = 0.046), higher significant carotid stenosis (i.e. > 50 %) (89 % vs. 30 %, p = 0.026) and higher severe carotid stenosis (i.e. >70 %) (67 % vs 19 %, p = 0.012), compared to those without stroke. Twenty (52 %) patients experienced relapses. High CRP at diagnosis was associated with relapses (p = 0.022). At the end of follow-up, 21 (58 %) patients were classified as having Takayasu arteritis, 13 (36 %) as isolated carotid vasculitis, and two (6 %) as giant cell arteritis.
CONCLUSIONS: Carotid vasculitis may occur as a topographically limited lesion and is associated with significant rate of vascular complications.