Diagnosis and management of giant cell arteritis: a review

Abstract

Further research is warranted concerning the immunogenetics of GCA. Further treatment trials are also needed to develop more specific and sensitive diagnostic tests and new corticosteroid-sparing treatment modalities.

Headache: When to Worry

“…It usually affects adults aged over 50 and there is a female preponderance with an incidence rate of 3:1 for women: men. Incidence increases with age as 15-25 cases per 100,000 have been reported in individuals aged more than 50 yrs [24] and it increased to 44.7 per 100,000 in individuals aged more than 80 yrs [25]. The scandinavian population has been shown to have a higher incidence rate as compared to any other population [26].…”

“…Diagnostic evaluation includes blood workup, temporal artery biopsy and neuroimaging. Elevated acute phase reactants such as ESR and C-reactive protein are important in the diagnosis, however, there is no specific blood marker for GCA [24]. Normochromic anemia and reactive thrombocytosis can also be noted.…”

“…MRI and angiography can aid in diagnosis, especially in biopsy negative patients. Differentials include various other vasculitis such as Takayasu arteritis, Varicella Zoster virus (VZV) infection, systemic amyloidosis and neoplastic disorders such as lymphoma [24]. In biopsy negative GCA patients VZV infection should be contemplated.…”

An 80-Year-Old Woman With Left-Sided Headache and Diplopia

“…Although the vast majority of microvascular CN palsies are nonarteritic, it is extremely important to always consider the possibility of an arteritic etiology, since ischemia of extraocular muscles or the motor nerves that innervate them occur in 2% to 15% of the cases of giant cell arteritis (GCA). 2 Among patients older than 50 years, GCA is the primary arteritic consideration, and all patients presenting with diplopia aged older than 50 years should be screened for other signs and symptoms of GCA, and complete blood count including platelets, ESR, and CRP should be obtained.…”

A case of giant cell arteritis with lower extremity myositis on MRI

“…[1][2][3][4] The disease is predominant in the elderly, with an average age of onset of 70 years. The prevalence is estimated to be 1 in 500 individuals of >50 years of age.…”