Giant Cell Arteritis Flashcards
What is Giant Cell arteritis?
Systemic vasculitis of medium/large arteries
What is giant cell arteritis AKA?
Temporal Arteritis because it usually affects temporal arteries
Who usually gets temporal arteritis?
- Caucasians
- Over 50
Presnetation of Giant cell arteritis?
Main= HEADACHE
- Severe unilateral headache around temples/forehead
- Scalp tenderness
- Jaw claudication
- Blurred/double vision
- Irreversible painless complete sight loss can occur
- Possible systemic symptoms
What are possible systemic symptoms?
Fever Wt loss Myalgia Muscle aches Fatigue Loss of appetite Peripheral oedema
Definitive diagnosis of giant cell arteritis is based on?
Clinical presentation
Raised ESRL usually
Temporal artery biopsy
What type of cells are found in temporal artery biopsy?
Giant multinucleated cells
Additional investigations of giant cell arteritis?
FBCs
Liver Function tests
C Reactive protein (usually raised)
Duplex US of temporal arteries shows hypoechoic halo sign
What does a duplex US show in tempral arteritis?
Hypoechoic halo sign
Initial management of temporal arteritis?
STEROIDS: Immediate before confirming diagnosis
(40-60mg prednisolone)
Others: aspirin, PPIs
When would you give a 60mg dose of prednisolone?
If jaw claudication or visual symptoms are present
Once a diagnosis of temporal arteritis is confirmed?
Continue high dose steroids (40-60mg) until symptoms resolve
Additional care in giant cell arteritis?
DONT STOP pneumonic
Early complications of GCA?
Neuro-ophthalmic:
- Vision loss
- Cerebrovascular accident
Late complications of GCA?
- Relapses common
- Steroid related SEs /comp
- Stroke/neurovascular incident
- Aortitis-> aortic aneurysm & aortic dissection
