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Emergency: requires immediate attention
Giant cell arteritis
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Other Resources UpToDate PubMed
Emergency: requires immediate attention

Giant cell arteritis

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Contributors: Michael W. Winter MD, Ryan Hoefen MD, PhD
Other Resources UpToDate PubMed

Synopsis

Giant cell arteritis (GCA) is a systemic vasculitis affecting medium- to large-sized arteries, including the aorta and the extracranial branches of the carotid artery. GCA is rarely found in individuals younger than 55, and the mean age for disease presentation is 76.

Patients may present with systemic symptoms such as new headache, anorexia, weight loss, neck pain, myalgia, fatigue, and anemia. There may be elevated erythrocyte sedimentation rate, temporal artery tenderness to palpation, or decreased arterial pulsation unrelated to arteriosclerosis. Patients may have scalp tenderness, visual disturbances, jaw claudication, or upper cranial palsies.

GCA and polymyalgia rheumatica (PMR) have a significant clinical association: 16%-21% of cases of PMR are associated with GCA, and 40%-60% of patients diagnosed with GCA also have PMR.
 
The most serious complication of GCA is blindness, a result of anterior ischemic optic neuropathy caused by ischemia secondary to inflammation of the ophthalmic artery supplying the optic nerve. All patients with suspected GCA should have temporal artery biopsy. Pathologic findings include a predominance of mononuclear cell infiltration or granulomatous inflammation, usually with multinucleated giant cells.

Scalp necrosis is a rare but potentially life-threatening complication.

For more information, see OMIM.

Codes

ICD10CM:
M31.6 – Other giant cell arteritis

SNOMEDCT:
230732009 – Cerebral arteritis in giant cell arteritis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 02/26/2019
Last Updated: 07/26/2017
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Emergency: requires immediate attention
Giant cell arteritis
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View all Images (10)
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Giant cell arteritis : Blurred vision, Fatigue, Fever, Headache, Jaw pain, Anorexia
Copyright © 2019 VisualDx®. All rights reserved.