{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:46:22Z","timestamp":1782794782587,"version":"3.54.5"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Giant cell arteritis (GCA) exhibits phenotypic heterogeneity. The diagnosis of large vessel involvement in GCA remains challenging, and conventional inflammatory markers have limitations. This study aimed to characterize phenotypic profiles and explore the role of novel hematological indices in an Asian cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective study enrolled 110 patients diagnosed with GCA between 2015 and 2025. Patients were classified into cranial (cGCA), mixed (mixGCA), and isolated large-vessel (LV-GCA) phenotypes. Demographics, clinical features, and laboratory parameters\u2014including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and serum albumin\u2014were analyzed. The performance of the 1990 ACR and 2022 ACR\/EULAR classification criteria was evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The cohort comprised 110 patients (65 men, 59.1%; 45 women, 40.9%), and was divided into cGCA (44.5%), mixGCA (36.4%), and LV-GCA (19.1%). LV-GCA presented with more constitutional symptoms and limb claudication but fewer cranial symptoms. Novel hematological indices, particularly SII and PLR, showed significant positive correlations with C-reactive protein levels. Multivariate logistic regression analysis revealed that serum albumin level was independently associated with large-vessel involvement (LVI; OR = 0.865, 95% CI [0.767\u20130.974],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.017). The 2022 ACR\/EULAR criteria had higher overall sensitivity (77.3%) than the 1990 ACR criteria (69.1%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>GCA presents a distinct clinical profile in this Asian cohort. Novel hematological indices (including SII and PLR) correlate with acute-phase reactants, and serum albumin is associated with LVI. These preliminary findings suggest that these biomarkers, alongside lower-limb arterial ultrasound, may aid in identifying LVI, requiring prospective validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1812045","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:25:31Z","timestamp":1782793531000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Phenotypic heterogeneity of giant cell arteritis in an Asian cohort: clinical, imaging, and laboratory characteristics"],"prefix":"10.3389","volume":"13","author":[{"given":"Xin","family":"Dang","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihuan","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine and Clinical Research, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongmei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1038\/s41584-021-00718-8","article-title":"Global epidemiology of vasculitis.","volume":"18","author":"Watts","year":"2021","journal-title":"Nat Rev Rheumatol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1122","DOI":"10.1002\/art.1780330810","article-title":"The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis.","volume":"33","author":"Hunder","year":"1990","journal-title":"Arthritis Rheum."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.1093\/rheumatology\/kex075","article-title":"Are the 1990 American College of Rheumatology vasculitis classification criteria still valid?","volume":"56","author":"Seeliger","year":"2017","journal-title":"Rheumatology."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1002\/art.41774","article-title":"2021 American College of Rheumatology\/Vasculitis Foundation Guideline for the management of giant cell arteritis and takayasu arteritis.","volume":"73","author":"Maz","year":"2021","journal-title":"Arthritis Rheumatol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"103413","DOI":"10.1016\/j.autrev.2023.103413","article-title":"Performance of the new 2022 ACR\/EULAR classification criteria for giant cell arteritis in clinical practice in relation to its clinical phenotypes.","volume":"22","author":"Narv\u00e1ez","year":"2023","journal-title":"Auto Rev."},{"key":"B6","doi-asserted-by":"publisher","first-page":"108","DOI":"10.3899\/jrheum.181127","article-title":"Factors associated with relapse and dependence on glucocorticoids in giant cell arteritis.","volume":"47","author":"Dumont","year":"2019","journal-title":"J Rheumatol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1111\/ced.14432","article-title":"A cutoff value for the systemic immune-inflammation index in determining activity of Beh\u00e7et disease.","volume":"46","author":"Tanacan","year":"2020","journal-title":"Clin Exp Dermatol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1016\/j.autrev.2017.05.014","article-title":"Recent advances in our understanding of giant cell arteritis pathogenesis.","volume":"16","author":"Samson","year":"2017","journal-title":"Auto Rev."},{"key":"B9","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1038\/nrrheum.2013.161","article-title":"Immune mechanisms in medium and large-vessel vasculitis.","volume":"9","author":"Weyand","year":"2013","journal-title":"Nat Rev Rheumatol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.autrev.2017.11.029","article-title":"Large-vessel involvement and aortic dilation in giant-cell arteritis. 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