Giant Cell Arteritis Flashcards
what is the most common form of systemic vasculitis in adults
GCA
who does GCA commonly occur in
older people
what are the histopathological signs
- transmural inflammation of the intima, media and adventitia of affected arteries
- patchy infiltration by lymphocytes, macrophages and multinuclear giant cells
- vessel wall thickening can result in arterial luminal narrowing resulting in subsequent distal ischemia
what are common signs and symptoms
visual disturbances, headache, jaw claudication and scalp tenderness
other constitutional manifestations (fatigue, malaise and fever)
when should GCA always be a differential
new onset headache in someone 50+ with elevated with an elevated ESR, CRP or plasma viscosity
what is the most significant cause of morbidity in GCA
visual loss
what percentage of patients can experience permanent visual loss
20%
what is characteristic of the headache
usually continuous and located in the temporal or occipital areas
focal tenderness on direct palpitation is typically present
can experience scalp tenderness with hair combing
what happens to the temporal artery
can be thickened and prominent and tender to touch
what is jaw claudication
fatigue or discomfort of the jaw muscles during chewing firm foods or prolonged speaking
what is jaw claudication the result of
ischemia of the maxillary artery
what percentage of people will experience visual symptoms throughout the course of the disease
50%
what are the visual symptoms
unilateral visual blurring or vision loss often painless or sometimes diplopia
what is the diagnosis based on
raised inflammatory markers
most definitive is temporal artery biopsy
what is the specificity and sensitivity of a temporal artery biopsy
specificity: 100%
sensitivity: 15-40%
