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 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 ultrasonography and/or biopsy is the definitive test to establish diagnosis.

Patients with jaw claudication, diplopia, and an abnormal temporal artery on examination are more likely to have a vascular ultrasonography and/or biopsy that is positive for GCA. GCA is unlikely if levels of inflammatory markers are normal.

Prednisolone is a highly effective therapy. Treatment should not be delayed while awaiting confirmatory test results.

Tocilizumab is a biological with therapeutic and glucocorticoid-sparing benefit in the treatment of GCA.

Giant cell arteritis (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 aged 50 years or older and is more common in women. The most common serious consequence of GCA is irreversible loss of vision due to optic nerve ischaemia. GCA is sometimes also referred to as temporal arteritis, cranial arteritis, or granulomatous arteritis.