Giant Cell Arteritis - week 17

Question 1

What is Giant cell arteritis?

Answer 1

vasculitis of medium and larger arteries (carotid arteries)

Question 2

Epidemiology of GCA?

Answer 2

highly linked with PMR (white women over 50)

Question 3

Presentation of giant cell arteritis (GCA)?

Answer 3

Severe unilateral headache typically around temple and forehead
Scalp tenderness my be noticed when brushing hair
Jaw claudication
Blurred or double vision
Irreversible painless complete sight loss can occur rapidly

Also systemic symptoms possible

Question 4

investigations into GCA?

Answer 4

temporal artery biopsy (positive for Multinucleated giant cells)
blood test - ESR/CRP
normocytic anaemia and thrombocytosis (raised platelets)
raised ALP

Question 5

Initial Management of GCA?

Answer 5

Start 40-60mg prednisolone per day

Aspirin 75mg daily decreases visual loss and strokes
Proton pump inhibitor when on steroids

Question 6

Ongoing Management of GCA?

Answer 6

high dose steroids (40-60mg) until symptoms resolve
then slowly wean off steroids

Question 7

Complications of GCA?

Answer 7

Vision loss
Cerebrovascular accident (stroke)

Relapses of the condition are common
Steroid related side effects and complications
Cerebrovascular accident (stroke)
Aortitis leading to aortic aneurysm and aortic dissection