Giant Cell Arteritis

Question 1

What is GCA?

Answer 1

A type of large-vessel vasculitis

Question 2

Where does GCA commonly affect?

Answer 2

Carotid artery and its extracranial branches

Question 3

What can GCA cause in the elderly?

Answer 3

Sudden vision loss

Question 4

How does GCA present?

Answer 4

Recent onset temporal headache, myalgia, malaise, fever. jaw claudication, diplopia, temporal artery may be prominent/tender, bruits over carotid/brachial artery

Question 5

When should you suspect GCA?

Answer 5

Headache with scalp tenderness and transient visual symptoms

Question 6

What criteria is used to diagnose GCA?

Answer 6

American College of Rheumatology (3 needed)

Question 7

What are the criteria for diagnosis?

Answer 7

ESR >50 mm an hour, temporal artery biopsy abnormality, >50, new headache, temporal artery abnormality

Question 8

What management do you start immediately?

Answer 8

Prednisolone high-dose unless ischaemic symptoms present

Question 9

What other management would you start?

Answer 9

Low-dose aspirin, tocillzumab

Question 10

What is tocillzumab?

Answer 10

A MA against IL-6 receptor