Giant Cell Arteritis

Cardiology (12%) Core Clinical Conditions

2A: Once the condition has been diagnosed, either by their supervising doctor or a clinical specialist, the Physician Associate is able to manage the condition without routine referral.

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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management

Giant cell arteritis (GCA) or temporal arteritis, is a type of vasculitis, which is inflammation of blood vessels. GCA primarily affects medium and large arteries, most frequently those in the head and neck region, specifically the temporal artery.

• Autoimmune causes

• Older age

• Infections: some viruses and bacteria

• Smoking has also been identified as a risk factor for the disease.

• Genetics

1. There is an inflammation of the medium and large arteries around the head and neck region.

2. There may be an autoimmune involvement in this.

3. There is the formation of giant cells which are formed by the fusion of macrophages.

4. If untreated, this can cause stroke, blindness and aneurysm.

• Age most common in those over the age of 50.

• Women are likely to develop GCA.

• Genetics

• Northern Europeans are more likely to develop GCA.

• Infections

• Smoking

• Chronic inflammatory disorders: such as rheumatoid arthritis (RA) and lupus

• Headache: A severe and persistent headache which may be located on one or both sides of the head.

• Jaw pain

• Visual disturbance: blurred vision, double vision, and sometimes sudden vision loss.

• Scalp tenderness

• Fatigue

• Fever

• Shoulders and hip pain.

• Loss of appetite

• Physical examination

• Blood tests: erythrocyte sedimentation rate (ESR) + C-reactive protein (CRP) levels, which are usually elevated in GCA.

• Biopsy: this is considered the gold standard for diagnosing GCA.

• This is a medical emergency and should be admitted to the hospital.

• The main treatment is high-dose corticosteroids, such as prednisone, if no visual disturbance 40 - 60 mg prednisolone and refer urgently to the Hospital. If diagnosed, review and follow up will be done by a specialist.

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