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Takayasu arteritis (AT) is a chronic granulomatous systemic vasculitis that affects large vessels and requires a multidisciplinary approach as the clinical signs are non-specific and disease activity is difficult to assess. Early rational drug treatment of AT suppresses both vascular and systemic inflammation, with glucocorticoids and immunosuppressants being of paramount importance. Advances in the understanding of the pathophysiology of AT have contributed to the development of new treatments that target key pro-inflammatory factors and involve the use of biologic disease-modifying antirheumatic drugs.

Large vessel vasculitis (LVV), including Takayasu's arteritis (AT, or non-specific aortoarteritis) and giant cell arteritis (GCA), is caused by granulomatous inflammation affecting mainly the aorta and its main branches. Damage to the vascular wall leads to ischemia of the corresponding organs and can be complicated by loss of vision, cerebral insufficiency and other life-threatening phenomena. The early diagnosis of these diseases in clinical practice is a difficult task that can only be solved by comparing the clinical symptoms, the results of the physical, laboratory and instrumental examination and the vascular biopsy.A comparative analysis of the 2018 and 2023 EULAR recommendations for imaging in LVV is presented. Duplex ultrasound (USDS) of not only temporal but also axillary arteries is recommended for GCA and magnetic resonance imaging (MRI) for AT. Alternative methods for GCA are MRI or positron emission tomography (PET) in combination with computed tomography (CT) and intravenous administration of fluorodeoxyglucose labelled with the short-lived fluoride isotope 18 (FDG-PET/CT), and for AT – FDG-PET/CT, CT or ultrasound examination. MRI, CT or ultrasound can be used for long-term monitoring of structural damage, especially to assess pre-existing vascular inflammation.

Systemic lupus erythematosus (SLE) is a multisystem disease characterized by chronic inflammation and damage to vital organs and systems. Despite the great success achieved in the treatment of SLE, glucocorticoids (GC) remain one of the main methods of therapy. The GC toxicity index is an objective method for assessing adverse events associated with their use, and in future studies can be actively used to monitor the safety of various therapy regimens. Wider introduction of this index in the management of patients with SLE will allow to optimize approaches to the selection of GC doses, to consider earlier prescription of biologic disease modifying antirheumatic drugs, before the development of severe irreversible damage.

The aim of the investigation was to study neuropsychic manifestations (NPM) of systemic lupus erythematosus (SLE) in the Kyrgyz cohort of patients. Material and methods. The prospective study included 460 patients with a reliable diagnosis of SLE, verified according to the diagnostic criteria ACR (1997) and SLICC (2012), observed in the clinic of the Academician M. Mirrakhimov National Center of Cardiology and Therapy from january 2012 to december 2017. Signs of nervous system damage were revealed in 103 (22.39%) of 460 patients with SLE. Classification criteria of ACR (1999) were used to assess neuropsychic manifestations of SLE, which were diagnosed by the psychiatrist according to ICD-10. Cognitive disorders were detected by a psychologist using a specific test Mini-Mental State Examination (MMSE; mini-scheme study of the mental state of the patient).Results and discussion. Various signs of NPM SLE were revealed in 103 (22.39%) of 460 patients with SLE. Groups of patients with and without NPM SLE at the beginning of the study were comparable in age, time from the appearance of the first signs of SLE to the verification of the diagnosis and the value of the SLEDAI-2K index (p>0.05). Acute variant of SLE course was significantly associated with NPM SLE. The acute course of SLE was observed in 56 (54.38%) of the 103 patients with NPM SLE and 109 (30.53%) of the 357 patients without NPM SLE [odds ratio (OR) 2.71, 95% confidence interval (CI) of 1.73–4.24; p