Giant cell arteritis Flashcards
(11 cards)
Define giant cell arteritis
Granulomatous inflammation of large arteries, particularly branches of the external carotid artery, most commonly the TEMPORAL ARTERY
Aetiology of giant cell arteritis
4
UNKNOWN
More common w/ increasing age
Some associations w/ ethnic background & infections
Associated w/ HLA-DR4 & HLA-DRB1
Epidemiology of giant cell arteritis
gender, age
More common in FEMALES
Peak age on onset 65-70 yrs
Presenting symptoms of giant cell arteritis
8
Subacute onset (usually over a few weeks)
Headache
Scalp tenderness
Jaw claudication
Blurred vision
Sudden blindness in 1 eye
Systemic - malaise, low grade fever, lethargy, weight loss, depression
Symptoms of polymyalgia rheumatica
- early morning pain & stiffness of muscles of shoulder & pelvic girdle
Signs of giant cell arteritis on physical examination
4
Swelling & erythema overlying temporal artery
Scalp & temporal tenderness
Thickened non-pulsatile temporal artery
Reduced visual acuity
Investigations for giant cell arteritis
2 types
Bloods
Temporal artery biopsy
Investigations for giant cell arteritis - bloods
2
High ESR
FBC - normocytic anaemia of chronic disease
Investigations for giant cell arteritis - temporal artery biopsy
(2)
Must be performed within 48 hrs of starting corticosteroids
Negative biopsy doesn’t necessarily rule out GCA
Management of giant cell arteritis
5
High dose oral prednisolone IMMEDIATELY to prevent visual loss
Reduce dose gradually
Many patients need to be kept on maintenance dose of prednisolone for 1-2 yrs
Low dose aspirin (w/ PPIs & gastric protection) - reduces risk of visual loss, TIAs & stroke
Annual CXR for up to 10 yrs to look for thoracic aortic aneurysms
Complications of giant cell arteritis
4
Carotid artery aneurysms
Aortic aneurysms
Thrombosis
Embolism to ophthalmic artery leading to visual disturbance & loss of vision
Prognosis of giant cell arteritis
Most cases condition lasts for around 2 yrs before complete remission
