Research summary
The 1990 American College of Rheumatology classification criteria for giant cell (temporal) arteritis were developed by comparing 214 patients with 593 patients with other forms of vasculitis, selecting five criteria including age ≥50 at onset, new localized headache, temporal artery tenderness or decreased pulse, ESR ≥50 mm/hour, and arterial biopsy showing necrotizing granulomatous arteritis [1]. The 1990 ACR Takayasu arteritis criteria were derived from 63 cases versus 744 controls, selecting six criteria including onset at age ≤40, extremity claudication, decreased brachial pulse, >10 mm Hg systolic difference between arms, subclavian/aortic bruit, and arteriographic narrowing or occlusion of the aorta or its primary branches [3]. The ACR Churg-Strauss criteria compared 20 cases with 787 controls, selecting six criteria (asthma, eosinophilia >10%, mono/polyneuropathy, non-fixed pulmonary infiltrates, paranasal sinus abnormality, extravascular eosinophils on biopsy), with four-of-six yielding 85% sensitivity and 99.7% specificity [4]. The ACR Wegener's granulomatosis criteria compared 85 cases with 722 controls, selecting four criteria (abnormal urinary sediment, abnormal chest radiograph, oral ulcers/nasal discharge, granulomatous inflammation on biopsy), with two-of-four yielding 88.2% sensitivity and 92.0% specificity [8]. The 1983 Annals of Internal Medicine paper reported 21-year experience with 85 Wegener's granulomatosis patients treated with cyclophosphamide (2 mg/kg/day) and prednisone (1 mg/kg/day converted to alternate-day), achieving complete remissions in 79 of 85 (93%) with mean remission duration of 48.2 months [6]. A 1997 PNAS paper demonstrated that highly purified CD4+ T cells from 13 patients on highly active antiretroviral therapy with undetectable plasma viremia (by bDNA) for an average of 10 months still carried integrated proviral DNA, establishing the inducible HIV-1 latent reservoir as a persistent obstacle to viral eradication despite effective HAART [7]. A 2020 JAMA Viewpoint reviews pathogenic human coronaviruses (SARS-CoV, MERS-CoV) as background for the emergence of 2019-nCoV and discusses containment public health strategies [2], complemented by a 2020 NEJM commentary on early Wuhan epidemiology and clinical features [5].
Recent publications
- The American College of Rheumatology 1990 criteria for the classification of giant cell arteritisDOI
- Coronavirus Infections—More Than Just the Common ColdDOI
- The American College of Rheumatology 1990 criteria for the classification of takayasu arteritisDOI
- The American College of Rheumatology 1990 criteria for the classification of churg‐strauss syndrome (allergic granulomatosis and angiitis)DOI
- The challenge of emerging and re-emerging infectious diseasesDOI
- Covid-19 — Navigating the UnchartedDOI
- Wegener's Granulomatosis: Prospective Clinical and Therapeutic Experience With 85 Patients for 21 YearsDOI
- Presence of an inducible HIV-1 latent reservoir during highly active antiretroviral therapyDOI
- The American College of Rheumatology 1990 criteria for the classification of wegener's granulomatosisDOI
- HIV infection is active and progressive in lymphoid tissue during the clinically latent stage of diseaseDOI
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External profiles
- ORCID: https://orcid.org/0000-0002-7865-7235
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