Giant cell Arteritis

Question 1

What is Giant Cell Arteritis?

Answer 1

Giant cell arteritis (GCA) is a granulomatous vasculitis of large and medium-sized arteries.

It primarily affects branches of the external carotid artery, and it is the most common form of systemic vasculitis in adults.

Question 2

What are the risk factors of giant cell arteritis?

Answer 2

> Age > 50

> Female

Question 3

What is the epidemiology of giant cell arteritis?

Answer 3

In Olmsted County, Minnesota, the average annual incidence is about 19 cases per 100,000 people 50 years of age or older. This is similar to that reported in northern European populations.

Question 4

What are the signs and symptoms of GCA?

Answer 4

Headache

Polymyalgia rheumatic symptoms

Extremity claudication

Cranial artery abnormalities

Systemic symptoms

Question 5

What are the investigations of GCA?

Answer 5

Bloods
> ESR (raised)
> CRP (raised)
> FBC (anaemia, WCC high, transaminases and alk phos mildly elevated)

Temporal artery biopsy- granulomatous inflammation

Temporal artery US- halo sign

Question 6

What are the complications of GCA?

Answer 6

> Large vessel stenoses

> Aortic aneurysms

> Glucocorticoid related adverse effects

> Vision loss

Question 7

What is the management of GCA?

Answer 7

> Prednisolone
Aspirin (adjunct)

+ methotrexate

Question 8

What is the prognosis of GCA?

Answer 8

The majority of patients respond rapidly to initial treatment with glucocorticoids, and vision loss in treated patients is rare. Can cause relapse and recurrence.