Giant cell arteritis

Giant cell arteritis (GCA) is a common form of vasculitis in people aged 50 years or older. The extracranial branches of the carotid artery (including the temporal artery) are usually affected.

Irreversible blindness is the most common serious consequence. Aortic aneurysms and large vessel stenoses may occur as a long-term complication.

Temporal artery biopsy is the definitive test to establish diagnosis, although ultrasonography is increasingly used in practice.

Symptoms include new onset of temporal headache, visual disturbances, and jaw or tongue claudication.

Prednisone is highly effective therapy. Treatment should not be delayed while awaiting biopsy.

Tocilizumab is a biologic with therapeutic and corticosteroid-sparing benefit in the treatment of GCA.

GCA is a granulomatous vasculitis of large and medium-sized arteries.[1]Ponte C, Grayson PC, Robson JC, et al. 2022 American College of Rheumatology/EULAR classification criteria for giant cell arteritis. Arthritis Rheumatol. 2022 Dec;74(12):1881-9. http://www.ncbi.nlm.nih.gov/pubmed/36350123?tool=bestpractice.com ​ It primarily affects branches of the external carotid artery, and it is the most common form of systemic vasculitis in adults. GCA typically occurs in people ages 50 years or older and is more common in women. Symptoms of polymyalgia rheumatica are frequently present. The most common serious consequence of GCA is irreversible loss of vision due to optic nerve ischemia. GCA is sometimes also referred to as temporal arteritis, cranial arteritis, or granulomatous arteritis.