Giant cell arteritis
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 difficulty chewing, 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. Some patients may experience transient vision loss. 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.
M31.6 – Other giant cell arteritis
230732009 – Cerebral arteritis in giant cell arteritis
- Aortic dissection
- Takayasu arteritis
- Kawasaki disease
- Carotid stenosis
- Cerebrovascular disease
- Arteriovenous fistula
- Intracranial neoplasm
- Acute angle-closure glaucoma
- Granulomatosis with polyangiitis
- Iritis / uveitis
- Migraine headaches
- Retinal artery occlusion (branch, central)
- Retinal vein occlusion (branch, central)
- Rheumatoid arthritis
- Polyarteritis nodosa
- VEXAS syndrome