Giant Cell Arteritis

Question 1

What is Giant Cell Arteritis also known as?

Answer 1

Temporal arteritis

Question 2

What are the symptoms of giant cell arteritis?

Answer 2

Unilateral headache
Jaw claudication
Blurred/loss of vision

Question 3

What is giant cell arteritis?

Answer 3

A large vessel vasculitis characterised by temporal artery inflammation

Question 4

What condition is giant cell arteritis associated with?

Answer 4

Polymyaglia rheumatica

Question 5

What are the investigations and diagnosis of giant cell arteritis?

Answer 5

Urgent referral to ophthalmology
↑ Platelets, ESR, CRP
Normocytic anaemia
Baseline LFTs, bone profile and U&Es to rule out other vasculitis diseases
Monitor risk of complications from steroid use with HbA1c, DEXA scan, and TFTs

Imaging

• Duplex ultrasound shows hypoechoic halo sign
• Temporal artery biopsy shows multinucleated giant cells
• MRI shows mural inflammation

Question 6

What is the management of giant cell arteritis?

Answer 6

• Visual loss→IV 500mg-1000mg methylprednisolone
• No visual loss → 40-60mg prednisolone OD, tapered down once symptoms and inflammatory markers resolve
• Safety netting to seek urgent help if symptoms get worse on steroids or vision loss
• Steroid protection: bisphosphonates, PPI