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.

Гигантоклеточный артериит

Última revisão: 20 Aug 2025
Última atualização: 22 Apr 2021

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • наличие факторов риска
  • головная боль
  • симптомы ревматической полимиалгии
  • перемежающаяся хромота
  • другие изменения краниальной артерии
  • потеря зрения
  • перемежающаяся хромота челюсти
  • болезненная чувствительность поверхностной височной артерии, уплотнение или узловатость
  • отсутствующий пульс височной артерии
  • измененное состояние глазного дна при осмотре
Detalhes completos

Outros fatores diagnósticos

  • системные симптомы
  • неврологические симптомы
  • кашель, боль в горле, охриплость
  • шумы, обнаруженные при аускультации
  • ассиметричное артериальное давление
  • болезненная чувствительность плеча
  • ограниченный объем активных движений плеч и бедер
  • отек запястья и колена
Detalhes completos

Fatores de risco

  • возраст> 50 лет
  • женский пол
  • наследственные факторы
  • курение
  • атеросклероз
  • факторы окружающей среды
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • Скорость оседания эритроцитов (СОЭ)
  • С-реактивный белок (СРБ)
  • развернутый анализ крови
  • Функциональные пробы печени
  • биопсия височной артерии
  • УЗИ височной артерии
Detalhes completos

Investigações a serem consideradas

  • ангиография дуги аорты
Detalhes completos

Novos exames

  • ПЭТ-сканирование с ФДГ от основания черепа до середины бедра
  • УЗИ артерий верхних конечностей

Algoritmo de tratamento

Inicial

подозрение на ГКА

CONTÍNUA

подтвержденный диагноз ГКА

Colaboradores

Autores

Kenneth J. Warrington, MD
Kenneth J. Warrington

Professor of Medicine

Mayo Clinic College of Medicine

Rochester

MN

Declarações

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.

Agradecimentos

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

Revisores

Gene Hunder, MD

Professor of Rheumatology

Mayo Clinic

Rochester

MN

Declarações

GH declares that he has no competing interests.

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

Consultant Rheumatologist

BHRT University Hospital

Queen’s Hospital

Romford

UK

Declarações

KC 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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Hunder GG, Bloch DA, Michel BA, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum. 1990 Aug;33(8):1122-8.Texto completo  Resumo

Dasgupta B, Borg FA, Hassan N, et al. BSR and BHPR guidelines for the management of giant cell arteritis. Rheumatology (Oxford). 2010 Aug;49(8):1594-7.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Diagnósticos diferenciais

    • Ревматическая полимиалгия (РП)
    • опухоли, локализованные в паренхиматозных органах и гематологические злокачественные новообразования
    • артериит Такаясу (TA)
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Tocilizumab for treating giant cell arteritis
    • Management of giant cell arteritis
    Mais Diretrizes
  • Videos

    Анимационная демонстрация венепункции и флеботомии

    Mais vídeos
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal