Giant Cell Arteritis

Question 1

Giant Cell Arteritis: General

Answer 1

Aka Hortons Disease
Chronic Systemic Vasculitis
* affects large and med arteries
* causes hyperplasia of intima-stenosis/occlusion
* result in ischemic manifestations
PMR symptoms (30-50%)

Question 2

Temporal arteritis affects what branches

Answer 2

• superficial temporal arteries
• ophthalmic A.
• posteior ciliary A.
• vertebral A.

Question 3

Upper Extremities arteritis affects what branches

Answer 3

• Subcalvian A.
• Axillary A.
• Proximal Brachial A.

Question 4

Lowre Extremities vasculitis affects what branches

Answer 4

• internal iliac
• superficial and deep femoral a.
• popliteal
• anterior tibial a.

Question 5

Aorta invovlement causes

Answer 5

• Aortic Dilation
• Forms aneursym
• leads to aortic dissection or rupture

Question 6

Polymyalgia Rheumatica (PMR)

Answer 6

• 30-50% of GCA pts
• > 50 y.o.
• Aching and stiff shoulders, neck, pelvic girdle
• Tx: low dose corticosteriods (Diagnostic)

Question 7

GCR: Epidemiology

Answer 7

• Most common vasculitis
• > 50 y.o.
• Females (2.5x)
• Scandinavian Descent

Question 8

GCR: Pathogenesis

Answer 8

Infectious Diseases:
* Mycoplasma pneumoniae
* Chlamydia pneumoniae
* parvovirus 19

Genetics: HLA-DRB1*04 allele

Question 9

GCR: Histopathology

Answer 9

• Inflammatory infiltrate all 3 layers of artery
• Form giant cell granulomas in media (middle layer)
• Obliterate Lamina
• Destroy medial vascular structures
• Intima Hyperplasia (inner layer)- OCCLUDES LUMEN=ISCHEMIA

Question 10

GCR: Clinical Presentation

Answer 10

Systemic Inflammation
* PMR
* Fatigue
* General Malaise
* Fever
* Anorexia
* Weight Loss
* Night sweats
* Increase acute phase reactants
* Abnorma liver enzymes
* Mild normochromic anemia

Question 11

GCR: Diagnosis

Answer 11

• Temporal Artery Biopsy=Gold Standard
• sample length 1-2 cm
• most definite evidence

Question 12

Biopsy: Histological features

Answer 12

*