Vasculitis (Giant Cell Arteritis) Flashcards
def vasculitis
inflammation of vessels
example of large, med, and small vasculitis
large - giant cell arteritis
medium - Kawasaki disese
small - IgA vasculitis
def of giant cell arteritis
large vessel vasculitis of the carotid artery and its branches (temporal, optical, and facial)
population for GCA
> 50
female
caucasian
cause of GCA?
its idiopathic, there is some sort of genetic and environmental factors
pathophys of GCA
- genetics and the environment ➔ inflammation in the vessels
- break down of the internal lamina
- can dev PMR s/s because of joint synovitis and tendonitis + muscle pains from vessel break down
- over time, the body can mount an immune rxn vs the damaged lamina
- recruit inflam mediators/acute phase reactants
- form granuloma in the vessel ➔ release VEGF
- causes lamina hyperplasia
- decrease blood flow
- claudication s/s
def of polymyalgia rheumatica
inflammatory disorder that results in the pain and stiffness in the neck, shoulders, and pelvic girdle
s/s of GCA
- new onset headache +/- scalp tenderness
- localized to the temporal area (+/-)
- jaw claudication
- vision changes
- constitutional s/s ➔ malaise/fatigue
- may have stroke s/s
- joint and muscle pains from the PMR
what questions would you ask on hx?
can you sit up out of your chair?
does it hurt going up the stairs
both asking about pelvic instability
can you blow dry your hair? can you take off your shirt
asking about shoulder pain/instability
how to ix giant cell arteritis?
colour doppler u/s ➔ halo sign
or temporal artery biopsy
how to tx GCA
if there are vision changes – admit + IV steroids STAT + opthalmology consult
no vision changes - consider oral steroids or doing dx imaging first
consider IL-6 inhibitors if recurrent GCA
arrange for f/u imaging CXR +/- abdo U/S for AAA risk
