Giant Cell Arteritis
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Definition Aetiology Pathophysiology Risk factor Sign and Symptoms Investigations Management
Definition
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.
Aetiology
Autoimmune causes
Older age
Infections: some viruses and bacteria
Smoking has also been identified as a risk factor for the disease.
Genetics
Pathophysiology
There is an inflammation of the medium and large arteries around the head and neck region.
There may be an autoimmune involvement in this.
There is the formation of giant cells which are formed by the fusion of macrophages.
If untreated, this can cause stroke, blindness and aneurysm.
Risk factors
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
Sign and symptoms
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
Investigations
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.
Management
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.