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Arterite de células gigantes

  • Descripción general
  • Teoría
  • Diagnóstico
  • Manejo
  • Seguimiento
  • Recursos
Última revisión: 30 May 2025
Última actualización: 05 Mar 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presença de fatores de risco
  • cefaleia
  • sintomas de polimialgia reumática
  • claudicação de membros
  • outras anormalidades das artérias cranianas
  • perda da visão
  • claudicação mandibular
  • sensibilidade na artéria temporal superficial, espessamento ou nodularidade
  • ausência de pulso da artéria temporal
  • fundoscopia anormal
Todos los datos

Otros factores de diagnóstico

  • sintomas sistêmicos
  • sintomas neurológicos
  • tosse, faringite, rouquidão
  • sopro na auscultação
  • pressão arterial assimétrica
  • sensibilidade dos ombros
  • amplitude de movimento ativa dos ombros e quadril limitada
  • edema do punho e joelho
  • dor de dente e dor ou infarto linguais
Todos los datos

Factores de riesgo

  • idade ≥50 anos
  • sexo feminino
  • fatores genéticos
  • tabagismo
  • aterosclerose
  • fatores ambientais
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • Velocidade de hemossedimentação (VHS)
  • proteína C-reativa
  • Hemograma completo
  • TFHs
  • biópsia da artéria temporal
  • ultrassonografia da artéria temporal
Full details

Tests to consider

  • exames de imagem vascular não invasivos
Full details

Emerging tests

  • tomografia por emissão de pósitrons com fluordesoxiglucose (FDG-PET) da cabeça até a metade da coxa

Treatment algorithm

INITIAL

suspeita de arterite de células gigantes (ACG)

ONGOING

arterite de células gigantes (ACG) confirmada

Contributors

Authors

Kenneth J. Warrington, MD
Kenneth J. Warrington

Professor of Medicine

Mayo Clinic College of Medicine

Rochester

MN

Disclosures

KJW’s employer receives payments from Eli Lilly, GSK, and Kiniksa for his role as investigator in giant cell arteritis clinical trials. KJW has conducted consulting work for Sanofi, and received compensation from Roche/Genentech for lecturing. He has received honoraria and consulting fees from Chemocentryx. KJW is an author of a number of references cited in this topic.

Acknowledgements

Dr Kenneth J. Warrington wishes to gratefully acknowledge Dr Eric L. Matteson, a previous contributor to this topic.

Disclosures

ELM’s employer has received payments from Bristol Meyers Squibb and GlaxoSmithKline for his role as investigator in giant cell arteritis clinical trials; from Novartis for his role in polymyalgia rheumatica clinical trials; and from GlaxoSmithKline for his role as an advisory consultant. ELM is an author and editor for Up To Date and Paradigm, as well as an author of a number of references cited in this topic.

Peer reviewers

Anisha B. Dua, MD, MPH

​Associate Professor

Northwestern University Feinberg School of Medicine

Chicago

IL

Disclosures

ABD declares they have paid consultancies from Amgen, Abbvie, Novartis, GSK and Sanofi. ABD is on the board of directors for the Vasculitis Foundation.

Kuntal Chakravarty, FRCP (London), FRCP (Glasgow), FRCP (Ireland), FACP (USA), FACR (USA)

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Disclosures

KC declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

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. Abstract

Maz M, Chung SA, Abril A, et al. 2021 American College of Rheumatology/Vasculitis Foundation guideline for the management of giant cell arteritis and Takayasu arteritis. Arthritis Rheumatol. 2021 Aug;73(8):1349-65.Full text  Abstract

Dejaco C, Ramiro S, Bond M, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice: 2023 update. Ann Rheum Dis. 2023 Aug 7:ard-2023-224543.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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