Giant Cell Arteritis

Question 1

Giant Cell Arteritis:

What is it and who/what it effects?

Answer 1

• Systemic vasculitis
• typically impacting cranial arteries, aorta and its branches
• most common in >70yo
• Women > Men
• occurs in 15% of PMR patients

Question 2

Giant Cell Arteritis:

Symptoms/diagnosis?

Answer 2

Jaw claudication
severe headaches
diplopia
malaise
enlarged temporal artery

CRP and ESR can be normal - but are usually elevated

Gold standard is a temple artery biopsy (hard to get done)

duplex USS

• increased diameter of the superficial temporal artery and hypoechoic wall thickening (halo sign) with duplex ultrasound
• sensitivity is 87% and specificity is 96%

MRI can be used but is about the same sensitivity and specificity at this stage to duplex USS

Question 3

Giant Cell Arteritis:

Management?

Answer 3

DO NOT DELAY PREDNISOLONE

Refer histology in less than 7 days from diagnosis

Prednisolone

1) 40 - 60mg for 4 weeks
2) reduce by 10mg per fortnight until 20mg
3) reduced by 2.5mg per fortnight until 10mg
4) reduced by 1mg per month until ceased