| Abstract | GCA je sistemski imunosno posredovani vaskulitis i najčešći je tip arteritisa. Ovom retrospektivnom studijom je dokazano da je GCA bolest starije životne dobi i da se uglavnom javlja iznad 50. godine života. Nakon 50. godine incidencija se progresivno povećava te je najviše ispitanika, njih 70,21% hospitalizirano u dobi iznad 70 godina. Dva do tri puta se češće javlja u žena nego u muškaraca. Simptomi GCA se mogu javiti postepeno ili naglo, i uglavnom nisu prepoznati na vrijeme. U prosjeku je najviše ispitanika, njih 25,58% hospitalizirano tek nakon četiri tjedna od prve pojave simptoma. Najčešći simptomi bolesti jesu glavobolja koja je prisutna kod 88,89% ispitanika, zatim febrilitet, umor i gubitak tjelesne mase. Prije postavljanja dijagnoze GCA i uvođenja terapije svi ispitanici ove studije imaju povišene upalne parametre (SE i CRP). Dijagnoza se postavlja na temelju kliničke slike i laboratorijskih nalaza, a potvrđuje se pozitivnim patohistološkim nalazom biopsije TA. Biopsija je ujedno i zlatni standard u dijagnozi GCA te je pozitivna kod 81,25% ispitanika, iako negativan nalaz ne isključuje dijagnozu. Terapiju je u principu potrebno odmah primijeniti, čak i ako treba odgoditi biopsiju. Osnova liječenja GCA su visoke doze sistemskih GK. Imunosupresivni lijekovi kao AZA i MTX se mogu dodavati u terapiji. Njihova primjena dovodi do smanjenja kumulativne doze GK i manjeg broja relapsa same bolesti. U novije vrijeme sve je učestalija i primjena imunosupresivnog lijeka TCZ koji je ujedno nova i obećavajuća terapija u liječenju GCA te 5,88% ispitanika ima u terapiji uz GK i TCZ. |
| Abstract (english) | GCA is systemic immune-mediated vasculitis and is the most common type of arteritis. This retrospective study proved that GCA is a disease of older age and that it mainly occurs above the age of 50. After the age of 50, the incidence progressively increases and most of the respondents, 70,21% of them, were hospitalized over the age of 70. It occurs two to three times more often in women than in men. GCA symptoms can occur gradually or suddenly, and are generally not recognized on time. On average, most respondents, 25,58% of them, were hospitalized only four weeks after the first onset of symptoms. The most common symptoms are headache, which is present in 88,89% of respondents, followed by fever, fatigue and weight loss. Before diagnosing GCA and initiating therapy, all subjects in this study had elevated inflammatory parameters (SE and CRP). The diagnosis is made on the basis of the clinical picture and laboratory findings, and is confirmed by a positive pathohistological finding of the TA biopsy. Biopsy is also the gold standard in the diagnosis of GCA and is positive in 81,25% of subjects, although a negative finding does not exclude the diagnosis. Therapy should in principle be applied immediately, even if the biopsy needs to be postponed. The basis of GCA treatment is high doses of systemic GC. Immunosuppressive drugs such as AZA and MTX can be added in therapy. Their application leads to a reduction in the cumulative dose of GK and a smaller number of relapses of the disease itself. Recently, the use of the immunosuppressive drug TCZ, which is also a new and promising therapy in the treatment of GCA, is becoming more frequent. |
