What is the pathophysiology of giant cell-mediated vasculitis

Updated: Dec 10, 2018
  • Author: Nadia Jennifer Chiara Luca, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

Takayasu arteritis and temporal arteritis (in adults) both involve large elastic arteries and share a similar histopathology. This form of vasculitis is T-cell dependent, and CD4+ T cells are the main players in the process. Dendritic cells within the arterial adventitia recruit and stimulate the CD4+ cells, which then activate the monocytes and macrophages that mediate oxidative injury of the vessel wall. Vascular lesions are characterized by a panarteritis with mononuclear infiltration of all layers of the arterial wall. Typically, activated T cells and macrophages are arranged in granulomas, and multinucleated giant cells are present. Often, the intimal layer is hyperplastic, leading to concentric occlusion of the lumen. Also, the end stage of giant-cell aortitis may be complicated by the formation and rupture of aneurysms. [10]


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