Giant Cell Arteritis

Question 1

What is GCA?

Answer 1

Chronic vasculitis of large and medium sized vessels

Question 2

Who is affected by GCA?

Answer 2

Those over 50 years of age

Question 3

What are the risk factors for GCA?

Answer 3

• 50+ age
• 2-4 x more common in women
• Common in whites
• Strong association with polymyalgia rheumatica
• Genetic predisposition - HLA-DR4 gene

Question 4

What are the symptoms of GCA?

Answer 4

• Headache - localised, boring - over temple
• Tongue/jaw claudication upon mastication
• Constitutional symptoms
• Visual symptoms - amaurosis fugal, blindness, diplopia, blurring
• Scalp tenderness - over temporal artery

Question 5

How is GCA diagnosed?

Answer 5

Presence of any 2 or more of these in patients over 50 years

• Raised ESR, CRP or PV
• New onset localised headache
• Tenderness or decreased pulsation of temporal artery
• New visual symptoms
• Biopsy showing necrotising arteritis

Question 6

How is GCA treated?

Answer 6

• Prednisolone 60-100mg PO daily for 2 weeks, then taper down slowly
• Acute onset visual symptoms - 1g methylprednisolone IV pulse therapy for 1-3 days
• Low dose aspirin therapy - reduce thrombotic risks