Rheumatology: Giant Cell Arthritis

Question 1

What is GCA?

Answer 1

Chronic vasculitis of large/medium sized vessels - pts aged >50yrs

Most commonly causes inflam of arteries originating from the aortic arch

Question 2

What are the signs and symptoms of GCA?

Answer 2

Headache - localised, unilateral, over the temple

Tongue/jaw claudication

Visual - amaurosis fugax, blindness, diplopia, blurring

Scalp tenderness - particularly over the temporal artery

Question 3

How is a diagnosis of GCA made?

Answer 3

Presence of any 2 or more of the following in patients >50 years with:

• Raised ESR, CRP or PV
• New onset of localized headache
• Tenderness or decreased pulsation of temporal artery
• New visual symptoms
• Biopsy revealing necrotizing arteritis

Question 4

How is GCA managed?

Answer 4

Prednisolone 60–100 mg PO per day for at least 2 weeks before considering tapering down slowly

For acute onset visual symptoms, consider 1g methylprednisolone IV pulse therapy for the 1–3 days

Low-dose aspirin therapy to reduce thrombotic risks