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Giant cell arteritis (GCA) rapidly responds to high-dose corticosteroids. However, smouldering arterial inflammation can persist despite the absence of symptoms and altered acute phase reactants. In patients that are refractory, symptoms relapse during steroid tapering and vascular complications may develop. The erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are not sensitive enough markers to detect refractory disease.1 The neuroendocrine system regulates innate and acquired immune responses, influencing cytokine synthesis and limiting tissue damage via release of neurotransmitters and peptides in peripheral tissues. Chromogranin A in particular is a candidate marker linking neurogenic inflammation and vascular inflammation.2 We investigated by ELISA, as described previously,3 the …
Competing interests: None declared.
Funding: This work was supported by the AIRC, the MIUR (PRIN 2004 and 2005; FIRB 2003) and the Ministero della Salute.
Ethics approval: Ethics approval was obtained.
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