Giant cell arteritis

Question 1

Define Giant cell arteritis

Answer 1

Type of AID affecting large arteries (aorta, temporal arteries, etc)
also called temporal arteritis
Mainly affecte hear vessels

Question 2

Aetiology and risk factors of Giant cell arteritis

Answer 2

Inflammation of the cells around arteries-causing smaller lumen -> ischemia in time
Granulomatous inflame of wall, after initial insult -hypersensitive dendritic cells activate and activate T cells–> causes proliferation and inflammation

Risk factors
age-50 or older
Women 2x> men
Smoke

Question 3

Epiemology of Giant cell arteritis

Answer 3

about 10 per 100 000

Question 4

Signs and Sx of Giant cell arteritis

Answer 4

If temporal artery affected-headache and tenderness over the eye (where artery is), and cannot feel pulse. bruits in affected area

Fundoscopy- can have

if mandibular-cramping there

if eye vessels-can get visual loss as ischemia develops

MSK exam fine

so present often with temporal headache,–want to ask for jaw claudication and vision change

(often one sided headache, pain when eating, )

very fast response to steroids
self limiting over 18 months

Question 5

Investigations of Giant cell arteritis

Answer 5

ESR and CRP are raised
typically ESR over 50
Abnormal Temporal artery ultrasound-halo sign
Temporal artery biopsy

Question 6

Management of Giant cell arteritis

Answer 6

Prednisolone at high dose -responds fasts

but self limiting over 18months

Question 7

Complications of Giant cell arteritis

Answer 7

Bad QOL if not treated

vision loss as ischemia damage

large vesel stenosis
aortic aneurysm

steroid related-over 18 month high dose is a lot-bushings

Question 8

Prognosis of Giant cell arteritis

Answer 8

Usually self limiting and steroids help a lot
can get occasional replapses and Sx
no affect on survival chance
but aortic aneurysm common afterwards
possible increase CVD risk