Is herpes zoster the cause of giant cell arteritis?

No detection of varicella-zoster virus in temporal arteries of patients with giant cell arteritis

Muratore F, Croci S, Tamagnini I, et al.

Semin Arthritis Rheum 2017; 47:235-240.

 

Abstract

Objective:

Data on the presence of varicella-zoster virus (VZV) in temporal arteries of patients with giant cell arteritis (GCA) are controversial. We analyzed VZV infection in temporal arteries from Italian patients with temporal artery biopsy (TAB)-positive GCA, TAB-negative GCA, and controls.

Methods:

A total of 79 formalin-fixed, paraffin-embedded (FFPE) TABs performed between 2009 and 2012 at a single institution from 34 TAB-positive GCA patients, 15 TAB-negative GCA patients, and 30 controls were retrieved. Six 5-μm sections of all FFPE TABs were cut. The first section was analyzed by immunohistochemistry using mouse monoclonal anti-VZVgE IgG1 antibody. DNA was extracted from the remaining five sections and analyzed by real-time polymerase chain reaction (PCR) for the presence of VZV DNA. For 10 of the 34 TAB-positive GCA patients, an additional 2-mm piece of frozen TAB was available. DNA was extracted from the entire 2-mm length frozen specimen and analyzed by PCR for the presence of VZV DNA. Thirty additional 5-μm sections were cut from the FFPE TABs of these 10 patients and analyzed by immunohistochemistry for the presence of VZV antigen.

Results:

Immunohistochemical analysis detected VZV antigen in 1/34 (3%) TAB-positive GCA, 0/15 TAB-negative GCA, and 0/30 controls, and in none of the 300 sections cut from the 10 FFPE TABs positive for GCA for which the frozen specimens were available. DNA obtained from all TABs was amplifiable. VZV DNA was neither found in any of the FFPE TABs nor found in frozen TABs.

Conclusion:

Our data do not support in Italian patients a possible role for VZV infection in the etiopathogenesis of GCA.

 


The following previous studies report an association between VZV and GCA

  • Gilden D, White T, Khmeleva N, Boyer PJ, Nagel MA. VZV in biopsy-positive and -negative giant cell arteritis: Analysis of 100+ temporal arteries. Neurol Neuroimmunol Neuroinflamm 2016; 3:e216.
  • Nagel MA, White T, Khmeleva N, et al. Analysis of varicella-zoster virus in temporal arteries biopsy positive and negative for giant cell arteritis. JAMA Neurol 2015; 72:1281-1287.

All three references are cited in the neurochecklist:

Giant cell arteritis (GCA): diagnosis and management

Abstract link 1

Abstract link 2

Abstract link 3

By Mikael HäggströmFile:Gray510.png, Public Domain, Link
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