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GIANT CELL ARTERITIS (Temporal or Cranial Arteritis)

GIANT CELL ARTERITIS (Temporal or Cranial Arteritis). Idiopathic vasculitis Same disease spectrum as polymyalgia rheumatica Mainly women 65-80 years old Medium and large arteries in head & neck involved. Headache Scalp tenderness Thickened temporal arteries Jaw claudication

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GIANT CELL ARTERITIS (Temporal or Cranial Arteritis)

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  1. GIANT CELL ARTERITIS(Temporal or Cranial Arteritis) • Idiopathic vasculitis • Same disease spectrum as polymyalgia rheumatica • Mainly women 65-80 years old • Medium and large arteries in head & neck involved

  2. Headache Scalp tenderness Thickened temporal arteries Jaw claudication Acute visual loss Weight loss, anorexia, fever, night sweats, malaise & depression GIANT CELL ARTERITISPresentation

  3. GIANT CELL ARTERITISOcular Complications • Transient monocular visual loss (amaurosis fugax) • Visual loss due to • Central retinal artery occlusion (CRAO) or • Anterior ischaemic optic neuropathy (AION) • Visual field defects

  4. GIANT CELL ARTERITISManagement • ESR if suspected • Start high dose steroids immediately to prevent stroke or second eye involvement • Temporal artery biopsy within a week of starting steroids

  5. GIANT CELL ARTERITIS Temporal Artery Biopsy • Arteries have skip lesions • ultrasound/Doppler may help identify involved areas • If positive, confirms diagnosis – helpful in management of future disease • If negative, doesn’t exclude diagnosis, but need to think about an alternative diagnosis

  6. GIANT CELL ARTERITISHistopathology • Granulomatous cell infiltration • Giant cells • Disruption of internal elastic lamina • Proliferation of intima • Occlusion of lumen

  7. GIANT CELL ARTERITISTreatment • Intravenous and oral steroids – prolonged course of steroids often necessary

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