Temporal arteritis

Question 1

What is giant cell arteritis?

Answer 1

Inflammation of the medium-large arteries that most commonly affects the temporal artery leading to temporal arteritis

Question 2

1) Temporal arteritis has a strong genetic link to what condition?
2) In what patient does temporal arteritis typically present in?

Answer 2

1) Polymyalgia rheumatica
2) White females older than 50

Question 3

1) The main presenting complaint is a headache - name 2 features of this headache/associated symptoms
2) Temporal arteritis can also present with systemic symptoms - name 2 of these

Answer 3

1) Severe unilateral headache typically around temple and forehead, scalp tenderness, jaw claudication, blurred or double vision, irreversible painless complete sight loss can occur rapidly
2) Fever, muscle aches, fatigue, weight loss, loss of appetite, peripheral oedema

Question 4

1) A definitive diagnosis of temporal arteritis is based on what 3 things?
2) What may be seen on a temporal artery biopsy in a patient with temporal arteritis?

Answer 4

1) Clinical presentation, raised ESR: usually 50 mm/hour or more, temporal artery biopsy findings
2) Multinucleated giant cells

Question 5

Before confirming diagnosis, what drug should be given, and what dosage regimen, and why?

Answer 5

Prednisolone 1mg/Kg immediately, then daily for 4 weeks then gradually tapered off for 6 months-year. Reduce the risk of permanent sight loss

Question 6

1) Name an early complication of temporal arteritis
2) Name a late complication of temporal arteritis

Answer 6

1) Vision loss and stroke
2) Relapses, steroid related side effects,
stroke, aortitis (aortic aneurysm and aortic dissection)

Question 7

How would it appear on fundoscopy?

Answer 7

Engorged swollen pale optic disc and blurred margin