Overview Giant cell arteritis affects medium and large arteries and can result in blindness. Giant Cell arteritis is common in the elderly. Consider Takayasu's arteritis if under 55yo. It is associated with polymyalgia rheumatica in 50% of cases.
| Remember Giant cell arteritis, the most common type of vasculitis in adults, affects medium and large arteries and can result in blindness |
Giant cell arteritis does not always involve the temporal artery and can affect other medium and large arteries including the aorta.
| Definition Giant cell arteritis: Systemic inflammatory vasculitis of unknown aetiology that occurs in older persons Polymyalgia rheumatica: Commonest inflammatory rheumatic disorder affecting older people. Patients typically present with bilateral shoulder pain, morning stiffness, raised inflammatory markers, and have a rapid response to low-dose corticosteroids Takayasu's arteritis: chronic granulomatous vasculitis affecting large arteries: primarily the aorta and its main branches. |
Clinical Presentation
| Remember Jaw claudication and visual symptoms are ischemic warning signs. |
| Polymyalgia rheumatica Commonest inflammatory rheumatic disorder affecting older people. Patients typically present with bilateral shoulder pain, morning stiffness, raised inflammatory markers, and have a rapid response to low-dose corticosteroids |
Diagnosis
| Remember Imperative to obtain adequate temporal artery biopsy (>2cm) because GCA presents as skip lesions |
| Side note ESR maybe normal initially |
Management
| Remember If you suspect GCA do ESR and start prednisolone immediately without waiting biopsy results! |
Prognosis
| Side note GCA and PMR are among the most common inflammatory rheumatic diseases in the elderly; the prevalence of these diseases is expected to increase due to ageing of the population |
