giant cell arteritis

Question 1

what is giant cell arteritis?

Answer 1

Chronic vasculitis of large- and medium-sized vessels that occurs among individuals over 50 yr. of age

often referred to as Temporal arteritis

most commonly causes inflammation of the arteries originating from the arch of the aorta

Question 2

what is an optic complication of occlusive arteritis?

Answer 2

can result in anterior ischaemic optic neuropathy and acute visual loss = an opthalmic emergency

Question 3

what does inflammation of arteries supplying the muscle of mastication result in?

Answer 3

jaw claudication and tongue discomfort

Question 4

what are the predisposing factors for giant cell arteritis?

Answer 4

• > 60yrs
• women
• Caucasian
• history of polymyalgia rheumatic

Question 5

what are the symptoms of giant cell arteritis?

Answer 5

• headache
• tongue or jaw claudication upon mastication
• visual findings e.g amaurosis fugax, blindness, diplopia and blurring
• scalp tenderness, especially over the temporal artery e.g when combing hair
• extracranial symptoms e.g malaise, dyspnoea, weight loss, morning stiffness and unequal/weak pulses.

Question 6

how is a diagnosis of GCA made?

Answer 6

presence of any 2 or more of the following in patients >50yrs =

• raised ESR, CRP, Plasma viscosity
• new onset localised headache
• tenderness or decreased pulsation of temporal artery
• new visual symptoms
• biopsy revealing necrotizing arteritis in temporal artery

Question 7

how is giant cell arteritis treated?

Answer 7

• treat immediately
• prednisolone 60-100mg PO per day for at least 2 weeks before considering tapering down
• acute onset visual symptoms, consider 1g methylprednisolone IV pulse therapy for 1-3 days
• low dose asprin to reduce thrombotic risk

Question 8

what is the most feared complication of GCA?

Answer 8

permanent visual loss

dont delay treatment of steroid therapy