Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- upper or lower limb claudication
- absent pulse(s)
- unequal blood pressures
- vascular bruits
- low-grade fever
Other diagnostic factors
- transient ischaemic attack (TIA)
- myalgia
- arthralgia
- weight loss
- fatigue
- dizziness on upper-limb exertion
- hypertension
- stroke
- chest pain
- abdominal pain
- diarrhoea
- shortness of breath
- haemoptysis
- night sweats
- vertigo
- syncope
- headache
- heart murmur
- visual symptoms
- erythema nodosum
- pyoderma gangrenosum
Risk factors
- genetic predisposition
- female sex
- age <40 years
- Asian ethnicity
Diagnostic investigations
1st investigations to order
- erythrocyte sedimentation rate (ESR)
- C-reactive protein (CRP)
- computed tomography angiography (CTA)
- magnetic resonance angiography (MRA)
Investigations to consider
- catheter angiogram
- Doppler ultrasound
- positron emission tomography with radiolabelled fluorodeoxyglucose (PET-FDG)
Treatment algorithm
all patients
Contributors
Authors
Kenneth J. Warrington, MD

Professor of Medicine
Mayo Clinic College of Medicine
Rochester
MN
Disclosures
KJW's employer receives payments from Eli Lilly, Kiniksa, and GlaxoSmithKline for his role as investigator in giant cell arteritis clinical trials. KJW has conducted consulting work for Sanofi. KJW is an author of a number of references cited in this topic.
Acknowledgements
Dr Kenneth J. Warrington would like to gratefully acknowledge Dr Steven R. Ytterberg and Dr Eric L. Matteson, previous contributors to this topic.
Disclosures
SRY declares that he was a sub-awardee of a grant from the US Food and Drug Administration for a pilot study of abatacept, a treatment for Takayasu's arteritis. SRY is also a member of the steering committee at the Vasculitis Clinical Research Committee. ELM declares that he has no competing interests.
Peer reviewers
Loic P. Guillevin, MD
Internal Medicine
Hopital Cochin-Paris University
St-Jacques
Paris
France
Disclosures
LPG declares that he has no competing interests.
Gene G. Hunder, MD
Department of Medicine
Division of Rheumatology
Mayo Clinic
Rochester
MN
Disclosures
GGH is an author of a reference cited in this topic. GGH declares that he has no other competing interests.
Differentials
- Giant cell arteritis (GCA)
- Essential hypertension
- Syphilis
More DifferentialsGuidelines
- Guideline for the management of giant cell arteritis and Takayasu arteritis
- Criteria for the classification of Takayasu arteritis
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