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30-05-2018 | Vasculitis | Review | Article

CNS Vasculitis: an Approach to Differential Diagnosis and Management

Journal: Current Rheumatology Reports

Authors: Kevin Byram, Rula A. Hajj-Ali, Leonard Calabrese

Publisher: Springer US

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Abstract

Purpose of Review

The goal of this review is to provide an up-to-date approach to diagnosis and management of patients with central nervous system (CNS) vasculitis.

Recent Findings

Challenges in diagnosis of CNS vasculitis still exist due to the broad differential diagnosis and generally nonspecific initial clinical manifestations. Differentiation between primary angiitis of the CNS (PACNS) and secondary causes is important in guiding management. Recent longitudinal cohort studies have improved our understanding of PACNS. Advances in neuroimaging and molecular testing have enhanced diagnostic decision-making. Therapy remains largely empiric, guided by observational data. Despite the limited use of targeted therapies, glucocorticoids and cyclophosphamide remain the mainstays of therapy in PACNS.

Summary

Securing a diagnosis through a careful, team-based approach with emphasis on ruling out possible mimics is paramount in the management of patients with CNS vasculitis.
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