Case report
Aortitis due to Giant Cell Arteritis and Psoriatic Arthritis: An Uncommon Association
Aortitis por arteritis de células gigantes y artritis psoriásica: una asociación infrecuente
M. del Pilar García-Cezón de la Cruza, Raquel Almodóvarb,
, Javier García Pérezc, Patricia Fanny Dhimesd, Pedro Zarcob
Corresponding author
a Unidad de Medicina Física y Rehabilitación, Hospital Universitario Fundación Alcorcón, Madrid, Spain
b Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Madrid, Spain
c Unidad de Radiología Vascular Intervencionista, Hospital Universitario Fundación Alcorcón, Madrid, Spain
d Unidad de Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Madrid, Spain
Read
6651
Timeswas read the article
1928
Total PDF
4723
Total HTML
Share statistics
array:24 [ "pii" => "S2173574317300345" "issn" => "21735743" "doi" => "10.1016/j.reumae.2016.03.013" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "911" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Reumatol Clin. 2017;13:230-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 789 "formatos" => array:3 [ "EPUB" => 74 "HTML" => 532 "PDF" => 183 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1699258X16300109" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2016.03.016" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "911" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Reumatol Clin. 2017;13:230-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4683 "formatos" => array:3 [ "EPUB" => 180 "HTML" => 3704 "PDF" => 799 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Caso clínico</span>" "titulo" => "Aortitis por arteritis de células gigantes y artritis psoriásica: una asociación infrecuente" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "230" "paginaFinal" => "232" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Aortitis due to giant cell arteritis and psoriatic arthritis: An uncommon association" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 606 "Ancho" => 1600 "Tamanyo" => 116205 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Angio-TAC: se confirma la presencia de un engrosamiento inflamatorio concéntrico/vasculitis de todos los troncos supraórticos (A) y del cayado aórtico (B) (flechas). La mayor afectación parece de la arteria subclavia izquierda, sin que se demuestren estenosis significativas a ningún nivel. En territorio carotídeo solo parece afectarse las carótidas comunes, sin extensión a ACI.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. del Pilar García-Cezón de la Cruz, Raquel Almodóvar, Javier García Pérez, Patricia Fanny Dhimes, Pedro Zarco" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M. del Pilar" "apellidos" => "García-Cezón de la Cruz" ] 1 => array:2 [ "nombre" => "Raquel" "apellidos" => "Almodóvar" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "García Pérez" ] 3 => array:2 [ "nombre" => "Patricia Fanny" "apellidos" => "Dhimes" ] 4 => array:2 [ "nombre" => "Pedro" "apellidos" => "Zarco" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574317300345" "doi" => "10.1016/j.reumae.2016.03.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300345?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X16300109?idApp=UINPBA00004M" "url" => "/1699258X/0000001300000004/v1_201706290122/S1699258X16300109/v1_201706290122/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173574317300369" "issn" => "21735743" "doi" => "10.1016/j.reumae.2016.03.014" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "914" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2017;13:233-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 707 "formatos" => array:3 [ "EPUB" => 60 "HTML" => 476 "PDF" => 171 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Cutaneous Manifestations in Antiphospholipid Syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "233" "paginaFinal" => "234" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Manifestaciones cutáneas del síndrome antifosfolípido" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2459 "Ancho" => 2833 "Tamanyo" => 1219443 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) Livedo reticularis in its variant, livedo racemose, involving both lower limbs in their entirety. (b) Purpuric discoloration on the second toe. (c) Skin displayed epidermal necrosis and the presence of hyaline thrombi in the papillary dermal vessels (hematoxylin–eosin, 100×). (d) Greater detail of the thrombi (hematoxylin–eosin, 20×).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Lucía Campos-Muñoz, Alejandro Fueyo-Casado, Jose Antonio Cortés-Toro, Eduardo López-Bran" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Lucía" "apellidos" => "Campos-Muñoz" ] 1 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Fueyo-Casado" ] 2 => array:2 [ "nombre" => "Jose Antonio" "apellidos" => "Cortés-Toro" ] 3 => array:2 [ "nombre" => "Eduardo" "apellidos" => "López-Bran" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1699258X16300134" "doi" => "10.1016/j.reuma.2016.03.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X16300134?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300369?idApp=UINPBA00004M" "url" => "/21735743/0000001300000004/v1_201707050008/S2173574317300369/v1_201707050008/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173574317300813" "issn" => "21735743" "doi" => "10.1016/j.reumae.2016.03.017" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "903" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Reumatol Clin. 2017;13:227-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 487 "formatos" => array:3 [ "EPUB" => 39 "HTML" => 304 "PDF" => 144 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Sarcoidosis: An unusual presentation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "227" "paginaFinal" => "229" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sarcoidosis: un cuadro clínico inicial poco frecuente" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1963 "Ancho" => 1737 "Tamanyo" => 386632 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Hand and feet skin lesions at presentation (A) and after 10 months of treatment (B).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Madureira, Sofia Pimenta, Hélder Cardoso, Rui Guimarães Cunha, Lúcia Costa" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Madureira" ] 1 => array:2 [ "nombre" => "Sofia" "apellidos" => "Pimenta" ] 2 => array:2 [ "nombre" => "Hélder" "apellidos" => "Cardoso" ] 3 => array:2 [ "nombre" => "Rui" "apellidos" => "Guimarães Cunha" ] 4 => array:2 [ "nombre" => "Lúcia" "apellidos" => "Costa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1699258X16000528" "doi" => "10.1016/j.reuma.2016.03.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X16000528?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300813?idApp=UINPBA00004M" "url" => "/21735743/0000001300000004/v1_201707050008/S2173574317300813/v1_201707050008/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Aortitis due to Giant Cell Arteritis and Psoriatic Arthritis: An Uncommon Association" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "230" "paginaFinal" => "232" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. del Pilar García-Cezón de la Cruz, Raquel Almodóvar, Javier García Pérez, Patricia Fanny Dhimes, Pedro Zarco" "autores" => array:5 [ 0 => array:3 [ "nombre" => "M. del Pilar" "apellidos" => "García-Cezón de la Cruz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "Raquel" "apellidos" => "Almodóvar" "email" => array:1 [ 0 => "ralmodovar@fhalcorcon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "Javier" "apellidos" => "García Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Patricia Fanny" "apellidos" => "Dhimes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:3 [ "nombre" => "Pedro" "apellidos" => "Zarco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Unidad de Medicina Física y Rehabilitación, Hospital Universitario Fundación Alcorcón, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Reumatología, Hospital Universitario Fundación Alcorcón, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Unidad de Radiología Vascular Intervencionista, Hospital Universitario Fundación Alcorcón, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Unidad de Anatomía Patológica, Hospital Universitario Fundación Alcorcón, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Aortitis por arteritis de células gigantes y artritis psoriásica: una asociación infrecuente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 606 "Ancho" => 1600 "Tamanyo" => 116205 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Computed tomography angiography: the presence of a concentric inflammatory thickening/vasculitis of all the supra-aortic branches (A) and of the aortic arch (B) is confirmed (arrows). The greatest involvement appears to be that observed in left subclavian artery, and there is no evidence of significant stenosis at any point. In the carotid territory, only the common carotid artery is affected, there being no extension to internal carotid artery.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Giant cell arteritis (GCA) is a systemic vasculitis involving medium and large vessels, with an annual incidence of 12–17 cases/100,000 population. It occurs more frequently in women and generally affects individuals over 50 years of age. The branches of the external carotid artery are those most commonly involved, although aortitis can develop in a certain subtype of patient. The involvement of the aorta is probably underestimated: subclinical aortitis has been detected in 20%–65% of the patients at diagnosis.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> It should be considered in those with atypical presentations of GCA, with data indicating systemic inflammation or a relapse during treatment,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> although it is asymptomatic in the majority of patients, or is manifested by means of systemic signs like fever or constitutional symptoms,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a> as observed in our patient.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On the other hand, psoriatic arthritis (PsA) has a prevalence of 0.5%, affecting between 5% and 20% of patients with psoriasis.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">4</span></a> In a retrospective study, Makredes et al. found that PsA had a higher prevalence ratio associated with GCA.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> To date, there have been reports of 2 patients with PsA who developed GCA.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">6,7</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case Report</span><p id="par0015" class="elsevierStylePara elsevierViewall">Our patient was a 65-year-old woman with a history of bronchial asthma, with bronchiectasis, and PsA with mixed erosive involvement; she was negative for HLA-B27. She had received methotrexate and leflunomide from 2011 until 2013, when they were interrupted because of remission. She was presented with a 2-month history of fever and weakness, but did not report headaches, vision disorders or chest, abdominal or limb pain. Physical examination revealed only a difference in arterial blood pressure of 20<span class="elsevierStyleHsp" style=""></span>mmHg and that some pulse rates were lower in left limbs. The temporal arteries were not tender on palpation, and the pulse rate was normal and symmetric. Laboratory tests showed a hemoglobin concentration of 9.9<span class="elsevierStyleHsp" style=""></span>g/dL (normal: 12.0–15.0), erythrocyte sedimentation rate of 102<span class="elsevierStyleHsp" style=""></span>mm/h (0–20), C-reactive protein 140.90<span class="elsevierStyleHsp" style=""></span>mg/L (<5<span class="elsevierStyleHsp" style=""></span>mg/L) and iron 11<span class="elsevierStyleHsp" style=""></span>μg/dL (35.0–145.0). The remaining parameters were normal (thyroid-stimulating hormone, creatine phosphokinase, Mantoux test, tumor markers, protein profile, serological tests, immunological tests, urinary sediment and cultures). Chest radiography, echocardiogram, gastroscopy with duodenal biopsy and colonoscopy were normal. Chest and abdominal computed tomography (CT) showed stable bronchiectasis and thickening of the abdominal aortic wall, indicative of aortitis. Computed tomography angiography (CTA) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) also showed evidence of concentric inflammatory thickening of the supra-aortic trunks and aortic arch. Temporal artery biopsy was performed with the histological confirmation of GCA. Treatment was begun with corticoids at a tapering dose starting with 2<span class="elsevierStyleHsp" style=""></span>mg/kg/day and methotrexate at 15<span class="elsevierStyleHsp" style=""></span>mg/weekly, and the symptoms disappeared.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">We present the case of a patient with PsA in remission who developed GCA. Reviewing the literature, we found only 2 other examples; in neither of them was aortic involvement associated with GCA. In 1989, Clementz et al.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">6</span></a> reported the case of a 63-year-old woman with PsA who developed GCA associated with pericarditis and pancreatic insufficiency. Corli et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">7</span></a> described that of a 62-year-old man with PsA and ulcerative colitis, treated with adalimumab, who developed GCA. They comment on whether anti-tumor necrosis factor (TNF) therapy could act as an inducer; they ultimately conclude that this association cannot be substantiated and appears to be merely a coincidence. Makredes et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">5</span></a> observed that PsA is more frequently associated with the development of other autoimmune diseases, such as inflammatory bowel disease (1.8 [1.3–2.5]), pulmonary fibrosis (1.9 [1.2–3.0]) and, above all, GCA (4.8 [1.5–15.7]). This may be due to the fact that certain autoimmune diseases share the same pathogenic pathways, like TNF, which is implicated in the pathogenesis of PsA and GCA. Elkayam et al.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">8</span></a> reported 5 cases of men diagnosed with ankylosing spondylitis who developed polymyalgia rheumatica (PMR). Another study showed a higher prevalence of spondyloarthritis (SpA) in patients newly diagnosed with large vessel vasculitis, specifically in 4 of the 15 patients included (6 with GCA and 9 with PMR). In addition, these patients with concomitant SpA were younger and had higher baseline C-reactive protein levels. The major limitation of that study is the small size of the sample, a circumstance that means that the authors were not able to draw significant conclusions.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">9</span></a> Recent pathophysiological findings suggest that vasculitis and SpA share a common inflammatory process: the expression of interleukin (IL) 22 was demonstrated in mouse aortic root, as well as in the initial SpA enthesitis, after exposure to IL-23.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">10</span></a> However, despite the findings of these studies, it is not clear whether there is an association between GCA and chronic SpA, or if they are simply 2 concurrent autoimmune diseases.</p><p id="par0025" class="elsevierStylePara elsevierViewall">On the other hand, aortitis secondary to GCA is a common subclinical entity.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> In most cases, this inflammatory aortitis is asymptomatic or is only manifested by systemic signs like fever and other constitutional symptoms,<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a> as in our patient. For the early diagnosis of aortitis due to GCA, both positron emission tomography (PET) and magnetic resonance imaging are effective.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a> The former using <span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose as a tracer shows an increased metabolic uptake in aorta in approximately 50% of the patients with GCA, enabling direct visualization of the extension of the vascular inflammation. Aortic CT scans provide images of aneurysmal dilatation, ectasia and focal or concentric parietal thickening. Occasionally, abdominal ultrasound makes it possible to visualize the thickening of the vascular wall, with a hypoechoic “halo” around the abdominal aorta, which is indicative of aortitis.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">1</span></a> Some authors propose performing screening for aortic complications based on chest radiography and abdominal ultrasound, possibly completed with CTA at the time of diagnosis, in order to prevent serious complications, like aneurysm rupture or aortic dissection.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The differential diagnosis of inflammatory diseases of the aorta comprises a wide spectrum of etiologies from infectious processes to noninfectious disorders like vasculitis, sarcoidosis and IgG4-related lymphoplasmacytic aortitis, and even as a cardiovascular complication secondary to SpA.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">11</span></a> The literature includes the description of 7 cases of abdominal aortitis due to SpA.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">12,13</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In terms of management, the involvement of the aorta and other great vessels in GCA does not change the treatment strategy, which is based initially on corticosteroid therapy.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusions</span><p id="par0040" class="elsevierStylePara elsevierViewall">The case presented here demonstrates the importance of screening for aortic involvement in GCA due to its prognostic and therapeutic implications. Finally, the coexistence between PsA and GCA seems to occur infrequently. At this time, the question as to whether there is an association, or if they simply represent 2 concurrent autoimmune diseases, will need to be evaluated in future studies.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Ethical Disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of human and animal subjects</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this study.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Confidentiality of data</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their work center on the publication of patient data.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Right to privacy and informed consent</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors have obtained the written informed consent of the patients or subjects mentioned in the article. The corresponding author is in possession of this document.</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflicts of Interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres859826" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec853936" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres859827" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec853935" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Case Report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conclusions" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Protection of human and animal subjects" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of Interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2016-01-12" "fechaAceptado" => "2016-03-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec853936" "palabras" => array:3 [ 0 => "Psoriatic arthritis" 1 => "Aortitis" 2 => "Giant cell arteritis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec853935" "palabras" => array:3 [ 0 => "Artritis psoriásica" 1 => "Aortitis" 2 => "Arteritis células gigantes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">We report the case of a 65-year-old woman with psoriatic arthritis who developed aortitis secondary to giant cell arteritis. She presented with a 2-month history of dry cough, fever and fatigue. There was no evidence of tumor or infectious processes. Abdominal computed tomographic and computed tomography coronary angiographic findings were suggestive of aortitis. Histological study of a temporal artery biopsy confirmed temporal arteritis. We also review the available literature on this uncommon condition.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una mujer de 65 años seguida por artritis psoriásica, que desarrolló una aortitis por arteritis de células gigantes, con un comienzo de tos seca, fiebre y astenia de 2 meses de evolución. Se realizó estudio descartando procesos tumorales e infecciosos y evidenciándose en la TAC abdominal y la angio-TAC datos indicativos de aortitis. Se realizó biopsia de arteria temporal con confirmación histológica de arteritis de células gigantes. Realizamos una revisión de la información disponible sobre esta infrecuente asociación.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Cezón de la Cruz MP, Almodóvar R, García Pérez J, Dhimes PF, Zarco P. Aortitis por arteritis de células gigantes y artritis psoriásica: una asociación infrecuente. Reumatol Clin. 2017;13:230–232.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 606 "Ancho" => 1600 "Tamanyo" => 116205 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Computed tomography angiography: the presence of a concentric inflammatory thickening/vasculitis of all the supra-aortic branches (A) and of the aortic arch (B) is confirmed (arrows). The greatest involvement appears to be that observed in left subclavian artery, and there is no evidence of significant stenosis at any point. In the carotid territory, only the common carotid artery is affected, there being no extension to internal carotid artery.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:13 [ 0 => array:3 [ "identificador" => "bib0070" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aortitis in giante cell arteritis and its complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "O. Espitia" 1 => "C. Agard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.revmed.2013.02.026" "Revista" => array:6 [ "tituloSerie" => "Rev Med Interne" "fecha" => "2013" "volumen" => "34" "paginaInicial" => "412" "paginaFinal" => "420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23523343" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0075" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aortic involvement in giant cell arteritis: current data" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Bossert" 1 => "C. Prati" 2 => "J.C. Balblanc" 3 => "A. Lohse" 4 => "D. Wendling" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jbspin.2010.09.013" "Revista" => array:6 [ "tituloSerie" => "Joint Bone Spine" "fecha" => "2011" "volumen" => "78" "paginaInicial" => "246" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21030278" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0080" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammatory aortitis in giant cell arteritis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Josselin-Mahr" 1 => "T.A. El Hessen" 2 => "C. Toledano" 3 => "L. Fardet" 4 => "A. Kettaneh" 5 => "K. Tiev" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.lpm.2012.03.003" "Revista" => array:6 [ "tituloSerie" => "Presse Med" "fecha" => "2013" "volumen" => "42" "paginaInicial" => "151" "paginaFinal" => "159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22552044" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0085" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalence of psoriasis in Spain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Ferrandiz" 1 => "X. Bordas" 2 => "V. Garcia-Patos" 3 => "S. Puig" 4 => "R. Pujol" 5 => "A. Smandia" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2001" "volumen" => "15" "paginaInicial" => "20" "paginaFinal" => "23" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11451315" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0090" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The burden of autoimmune disease: a comparison of prevalence ratios in patients with psoriatic arthritis and psoriasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Makredes" 1 => "D. Robinson" 2 => "M. Bala" 3 => "A.B. Kimball" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2009.02.015" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2009" "volumen" => "61" "paginaInicial" => "405" "paginaFinal" => "410" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19700012" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0095" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Giant cell arteritis associated with pericarditis and pancreatic insufficiency in a patient with psoriatic arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.L. Clementz" 1 => "F. Gold" 2 => "N. Khaiser" 3 => "W.D. Zolin" 4 => "L. Jalovec" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rheumatol" "fecha" => "1989" "volumen" => "16" "paginaInicial" => "128" "paginaFinal" => "129" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0100" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Giant cell arteritis occurring during psoriatic arthritis treated by adalimumab" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Corli" 1 => "L. Lemeunier" 2 => "N. le Gouellec" 3 => "R.M. Flipo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jbspin.2014.11.003" "Revista" => array:6 [ "tituloSerie" => "Joint Bone Spine" "fecha" => "2015" "volumen" => "82" "paginaInicial" => "291" "paginaFinal" => "292" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25686529" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0105" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polymyalgia rheumatica in patients with ankylosing spondylitis: a report of 5 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "O. Elkayam" 1 => "D. Paran" 2 => "M. Yaron" 3 => "D. Caspi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Rheumatol" "fecha" => "1997" "volumen" => "15" "paginaInicial" => "411" "paginaFinal" => "414" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9272303" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0110" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Large vessel vasculitis and spondyloarthritis: coincidence or associated diseases?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Ernst" 1 => "N.T. Baerlecken" 2 => "R.E. Schmidt" 3 => "T. Witte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3109/03009742.2013.850737" "Revista" => array:6 [ "tituloSerie" => "Scand J Rheumatol" "fecha" => "2014" "volumen" => "43" "paginaInicial" => "246" "paginaFinal" => "248" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24438209" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0115" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IL-23 induces spondyloarthropathy by acting on ROR-γt+CD3+CD4-CD8- entheseal resident T cells" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.P. Sherlock" 1 => "B. Joyce-Shaikh" 2 => "S.P. Turner" 3 => "C-C. Chao" 4 => "M. Sathe" 5 => "J. Grein" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nm.2817" "Revista" => array:6 [ "tituloSerie" => "Nat Med" "fecha" => "2012" "volumen" => "18" "paginaInicial" => "1069" "paginaFinal" => "1076" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22772566" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0120" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammatory ascending aortic disease: perspectives from pathology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.J. Maleszewski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jtcvs.2014.07.046" "Revista" => array:7 [ "tituloSerie" => "J Thorac Cardiovasc Surg" "fecha" => "2015" "volumen" => "149" "numero" => "2 Suppl" "paginaInicial" => "S176" "paginaFinal" => "S183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25199476" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0125" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal aortitis in HLA-B27+spondyloarthritis: case report with 5-year follow-up and literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.S. Grewal" 1 => "J. Leipsic" 2 => "A.V. Klinkhoff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semarthrit.2014.05.012" "Revista" => array:6 [ "tituloSerie" => "Semin Arthritis Rheum" "fecha" => "2014" "volumen" => "44" "paginaInicial" => "305" "paginaFinal" => "308" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24935530" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0130" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aortitis in a patient with psoriatic athritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Tufan" 1 => "M. Engin Tezcan" 2 => "A. Kaya" 3 => "R. Mercan" 4 => "Y. Oner" 5 => "M.A. Ozturk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10165-011-0566-9" "Revista" => array:6 [ "tituloSerie" => "Mod Rheumatol" "fecha" => "2011" "volumen" => "22" "paginaInicial" => "774" "paginaFinal" => "777" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22143340" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001300000004/v1_201707050008/S2173574317300345/v1_201707050008/en/main.assets" "Apartado" => array:4 [ "identificador" => "43296" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case report" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001300000004/v1_201707050008/S2173574317300345/v1_201707050008/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574317300345?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 15 | 26 |
| 2024 October | 76 | 37 | 113 |
| 2024 September | 75 | 13 | 88 |
| 2024 August | 101 | 35 | 136 |
| 2024 July | 118 | 20 | 138 |
| 2024 June | 96 | 37 | 133 |
| 2024 May | 92 | 38 | 130 |
| 2024 April | 106 | 25 | 131 |
| 2024 March | 83 | 31 | 114 |
| 2024 February | 68 | 24 | 92 |
| 2024 January | 78 | 22 | 100 |
| 2023 December | 49 | 26 | 75 |
| 2023 November | 85 | 31 | 116 |
| 2023 October | 51 | 23 | 74 |
| 2023 September | 90 | 29 | 119 |
| 2023 August | 73 | 14 | 87 |
| 2023 July | 76 | 37 | 113 |
| 2023 June | 90 | 22 | 112 |
| 2023 May | 80 | 21 | 101 |
| 2023 April | 70 | 18 | 88 |
| 2023 March | 117 | 39 | 156 |
| 2023 February | 98 | 24 | 122 |
| 2023 January | 60 | 9 | 69 |
| 2022 December | 98 | 37 | 135 |
| 2022 November | 88 | 34 | 122 |
| 2022 October | 78 | 28 | 106 |
| 2022 September | 64 | 44 | 108 |
| 2022 August | 78 | 41 | 119 |
| 2022 July | 50 | 45 | 95 |
| 2022 June | 68 | 25 | 93 |
| 2022 May | 64 | 36 | 100 |
| 2022 April | 88 | 57 | 145 |
| 2022 March | 120 | 53 | 173 |
| 2022 February | 111 | 28 | 139 |
| 2022 January | 100 | 34 | 134 |
| 2021 December | 54 | 43 | 97 |
| 2021 November | 57 | 45 | 102 |
| 2021 October | 90 | 46 | 136 |
| 2021 September | 57 | 42 | 99 |
| 2021 August | 56 | 34 | 90 |
| 2021 July | 63 | 29 | 92 |
| 2021 June | 63 | 28 | 91 |
| 2021 May | 85 | 44 | 129 |
| 2021 April | 181 | 81 | 262 |
| 2021 March | 106 | 74 | 180 |
| 2021 February | 60 | 30 | 90 |
| 2021 January | 60 | 15 | 75 |
| 2020 December | 69 | 17 | 86 |
| 2020 November | 77 | 12 | 89 |
| 2020 October | 32 | 12 | 44 |
| 2020 September | 57 | 27 | 84 |
| 2020 August | 54 | 25 | 79 |
| 2020 July | 23 | 27 | 50 |
| 2020 June | 45 | 20 | 65 |
| 2020 May | 26 | 9 | 35 |
| 2020 April | 11 | 29 | 40 |
| 2020 March | 14 | 4 | 18 |
| 2020 February | 2 | 0 | 2 |
| 2019 May | 1 | 0 | 1 |
| 2018 May | 4 | 1 | 5 |
| 2018 April | 66 | 8 | 74 |
| 2018 March | 72 | 9 | 81 |
| 2018 February | 41 | 5 | 46 |
| 2018 January | 33 | 7 | 40 |
| 2017 December | 39 | 12 | 51 |
| 2017 November | 54 | 13 | 67 |
| 2017 October | 45 | 10 | 55 |
| 2017 September | 37 | 12 | 49 |
| 2017 August | 58 | 27 | 85 |
| 2017 July | 60 | 37 | 97 |
| 2017 June | 7 | 13 | 20 |
| 2017 May | 9 | 9 | 18 |
| 2017 April | 2 | 15 | 17 |
| 2017 March | 3 | 5 | 8 |
Show all
