Giant Cell Arteritis Flashcards
What is giant cell arteritis?
Systemic vasculitis of the medium and large arteries.
What is another name for giant cell arteritis?
Temporal arteritis
What condition is giant cell arteritis strongly linked to?
Polymyalgia rheumatica
What is this a presentation of:
White female over 50 with a severe unilateral headache around forehead, recent blurred vision, some systemic symptoms?
Giant cell arteritis
How is giant cell arteritis diagnosed?
- Clinical presentation
- Raised ESR (>50mm/hour)
- Temporal artery biopsy
What are the findings on temporal artery biopsy of giant cell arteritis?
Multinucleated giant cells
What investigations would you consider in suspected giant cell arteritis?
- ESR (raised)
- Temporal artery biopsy
- FBC (normocytic anaemia and thrombocytosis)
- LFTs (raised ALP)
- CRAP (raised)
- Duplex US of temporal artery (hypoechoic halo)
What is the initial pharmaceutical management of giant cell arteritis?
- 40-60mg PO prednisolone OD - immediately, review within 48 hours.
- Aspirin 75mg PO OD - reduce thrombus risk
- PPI - gastric protection
Which three specialties would you refer a case of giant cell arteritis to and why?
- Vascular surgeons - biopsy
- Rheumatology - diagnosis and management
- Ophthalmology - review as emergency same day appointment (visual symptoms)
What considerations need to be made for long term steroid use?
- Weaning off over long period of time.
- Increase dose if they become unwell.
- Treatment card - alert others of steroid dependence.
- Osteoporosis prevention - bisphosphonates, calcium, vitamin D
- PPI - gastric protection
What are the early complications of giant cell arteritis?
- Vision loss
2. Cerebrovascular event
What are the late complications of giant cell arteritis?
- Condition relapse
- Steroid related side effects
- Cerebrovascular event
- Aortitis - aortic aneurysm and dissection
