Giant Cell Arteritis Flashcards
What is Giant cell arteritis?
Chronic vasculitis of large- and medium-sized vessels that occurs among individuals over 50 yr of age
Often referred to as temporal arteritis (TA) with a median age of onset at 72
What are the common complications of Giant cell arteritis?
- Anterior ischemic optic neuropathy (AION) and acute visual loss
- Inflammation of arteries supplying muscles of mastication results in jaw claudication and tongue discomfort
Visual symptoms are considered an ophthalmic emergency
What symptoms are associated with Giant cell arteritis?
- Headache
- jaw claudication
- tongue discomfort
- visual symptoms
- scalp tenderness especially over temporal artery
Headache is the most frequent symptom (70%) and visual symptoms may include amaurosis fugax, blindness, diplopia, and blurring
What is the greatest risk factor for Giant cell arteritis?
Age
Rare in patients <50 yr old; >90% are >60 yr old
What is the prevalence of Giant cell arteritis in individuals over 50 years?
Estimated at 1:500
Increased prevalence in Northern latitude and 2 to 4 times more common in women
What is the association between polymyalgia rheumatica and Giant cell arteritis?
Strong association with ~50% of patients
Genetic predisposition HLA-DR4
## Footnote
Polymyalgia rheumatica is a condition that often coexists with GCA
What are the diagnostic criteria for Giant cell arteritis?
Presence of any 2 or more of the following in patients >50 years:
- raised ESR, CRP, PV
- new onset of localised headache
- tenderness or decreased pulsation of temporal artery
- new visual symptoms
- biopsy revealing necrotizing arteritis
Diagnosis requires clinical suspicion and may not wait for biopsy results
What is the initial treatment for Giant cell arteritis?
Prednisolone 60-100 mg PO per day for at least 2 weeks
Low-dose aspirin therapy to reduce thrombotic risks
Consider tapering down slowly after initial treatment
What treatment is recommended for acute onset visual symptoms in Giant cell arteritis?
1g methylprednisolone IV pulse therapy for 1-3 days
This is to address severe visual symptoms quickly
True or False: Permanent visual loss is the most feared complication of Giant cell arteritis.
True
Timely treatment is critical to prevent this outcome
What percentage of untreated patients with acute loss of vision in one eye will develop bilateral blindness?
25-50%
This highlights the urgency of treatment in suspected cases of GCA
Fill in the blank: Inflammation of arteries supplying the muscles of mastication results in __________.
jaw claudication and tongue discomfort
What visual symptoms may develop weeks to months after the onset of other symptoms in Giant cell arteritis?
Amaurosis fugax, blindness, diplopia, and blurring
These symptoms indicate serious complications related to GCA
