Arterite de células gigantes

查看 PDF
  • 概述
  • 理论
  • 诊断
  • 治疗
  • 随访
  • 资源

When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

最后审阅： 28 Nov 2025
最后更新： 20 Aug 2024

小结

定义

病史和体格检查

关键诊断因素

  • presença de fatores de risco
  • cefaleia
  • dor ou sensibilidade no couro cabeludo
  • dor e rigidez
  • claudicação de extremidades (membros)
  • perda da visão
  • claudicação da mandíbula e da língua
  • sensibilidade arterial, espessamento ou nodularidade
  • ausência de pulso
  • fundoscopia anormal
完整详情

其他诊断因素

  • sintomas sistêmicos
  • sintomas neurológicos
  • sopro na auscultação
  • pressão arterial assimétrica
  • sensibilidade dos ombros
  • amplitude de movimento ativa dos ombros e quadril limitada
  • dor de dente e dor ou infarto linguais
完整详情

危险因素

  • idade ≥50 anos
  • sexo feminino
  • fatores genéticos
  • tabagismo
  • aterosclerose
  • fatores ambientais
完整详情

诊断性检查

首要检查

  • proteína C-reativa
  • Velocidade de hemossedimentação (VHS)
  • Hemograma completo
  • ultrassonografia vascular
  • biópsia da artéria temporal
  • testes da função hepática
  • testes de função renal
Full details

Tests to consider

  • PET com fluordesoxiglucose (FDG) da cabeça até a metade da coxa
  • RNM de alta resolução das artérias cranianas
Full details

Treatment algorithm

INITIAL

suspeita de arterite de células gigantes (ACG)

ONGOING

arterite de células gigantes (ACG) confirmada

Contributors

Expert advisers

Chetan Mukhtyar, MBBS, MSc, MD, FRCP

Consultant Rheumatologist and Service Director for Rheumatology

Norfolk and Norwich University Hospital

Norwich

UK

Biography

CM is a co-author on the British Society of Rheumatology guidelines on the management of giant cell arteritis and the EULAR recommendations for the management of large vessel vasculitis.

Disclosures

CM is a trustee of the British Society for Rheumatology. CM is an author of references cited in this topic.

Acknowledgements

BMJ Best Practice would like to gratefully acknowledge the previous expert contributors, whose work has been retained in parts of the content:

Kenneth J. Warrington, MD

Professor of Medicine

Mayo Clinic College of Medicine

Rochester

MN

Disclosures

KJW’s employer receives payments from Eli Lilly 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.

Peer reviewers

Gary Reynolds, BSc, MRCP, PhD

Wellcome Trust Clinical Career Development Fellow

Translational and Clinical Research Institute

Newcastle University

Honorary Consultant Rheumatologist

Freeman Hospital

Newcastle

UK

Biography

GR is a co-author on the British Society of Rheumatology guidelines on the management of giant cell arteritis.

Disclosures

GR declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

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

Hellmich B, Agueda A, Monti S, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020 Jan;79(1):19-30.Full text  Abstract

Mackie SL, Dejaco C, Appenzeller S, et al. British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritis. Rheumatology (Oxford). 2020 Mar 1;59(3):e1-e23.Full text  Abstract

Coath FL, Bukhari M, Ducker G, et al. Quality standards for the care of people with giant cell arteritis in secondary care. Rheumatology (Oxford). 2023 Sep 1;62(9):3075-83. 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. 2024 May 15;83(6):741-51.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.

  • Differentials

    • Polimialgia reumática (PMR)
    • Cânceres de órgãos sólidos e neoplasias hematológicas
    • Arterite de Takayasu
    More Differentials

  • Guidelines

    • British Society for Rheumatology guideline on diagnosis and treatment of giant cell arteritis
    • 2018 update of the EULAR recommendations for the management of large vessel vasculitis
    More Guidelines

  • Folhetos informativos para os pacientes

    Arterite de células gigantes

    Mais Folhetos informativos para os pacientes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal