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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
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
giant cell arteritis presentation
Headache

Scalp tenderness

Thickened temporal arteries

Jaw claudication

Acute visual loss

Weight loss, anorexia, fever, night sweats, malaise & depression

GIANT CELL ARTERITISPresentation
giant cell arteritis ocular complications
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
giant cell arteritis management
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
giant cell arteritis temporal artery biopsy
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
giant cell arteritis histopathology
GIANT CELL ARTERITISHistopathology
  • Granulomatous cell infiltration
  • Giant cells
  • Disruption of internal elastic lamina
  • Proliferation of intima
  • Occlusion of lumen
giant cell arteritis treatment
GIANT CELL ARTERITISTreatment
  • Intravenous and oral steroids – prolonged course of steroids often necessary