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Christian El-Hadad, Andrei Dan, Zoya Chaudhry, Mark Gans, Sarah chorfi, Arzu Chaudhry, Tara Landry; Aetiologies of Giant Cell Arteritis: A Systematic Review of the Literature from 1995 to 2015. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3856.
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Giant Cell Arteritis (GCA) is a common vasculitis that can lead to severe neuro-ophthalmological disorders. Despite its severity, its etiology is still unknown. We attempted to elucidate the aetiology of GCA through a systematic review of the literature.
We conducted a systematic review with two independent librarians concerning the aetiologies of GCA in which Medline, EMBASE, PubMed, Cochrane Library, Biosis Previews, Web of Science, Scopus, ClinicalTrials.gov, International Clinical Trial Registry Platform and International standard Randomized Controlled Trial Number Register were employed to search for relevant studies published from January 1995 to March 2015. Only studies with 10 or more subjects that were observational, cohort, randomized control trials or cross-sectional studies were included. In addition, only articles with biopsy-proven GCA in patients above 50 years of age with clear statistical data were selected. We extracted from each article the number of subjects, baseline demographics, cases and controls in addition to the odds ratios, confidence intervals, andP-values.
Of the 3410 studies whose abstracts were reviewed, 45 eligible abstracts were selected based on the inclusion criteria. These studies fell into one of the following categories: case-control [37 (82.2 %)], cohort [(5, 11.1 %)], cross-sectional [1 (2.2 %)], and meta-analysis [2 (4.4 %)]. 29 (64.4%) studies looked at genetic aetiologies, 11 (24.4%) studies assessed infectious aetiologies and 5 (11.1%) studies evaluated an immunological phenomenon. Only 15 studies were able to establish a relation between the presumed aetiology and GCA. The common finding across all of these studies was a genetic polymorphic mutation. However, none of these 15 studies examined the same gene. One study showed a significant relationship between HSV and GCA; however, a larger, more recent study did not confirm this initial finding.The results of this review strongly indicate an underlying genetic disposition for GCA. However, due to multiple polymorphisms of the various genes involved, it is difficult to establish causality between a specific genetic aetiology and GCA.
The results of this review strongly indicate an underlying genetic disposition for GCA. However, due to multiple polymorphisms of the various genes involved, it is difficult to establish causality between a specific genetic aetiology and GCA.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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