Diagnosis and management of giant cell arteritis: a review
- 1 November 2010
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Opthalmology
- Vol. 21 (6), 417-422
- https://doi.org/10.1097/icu.0b013e32833eae8b
Abstract
This article aims to provide a review of giant cell arteritis (GCA) clinical features, differential diagnosis, treatment options, and recent literature. GCA, first described by Horton et al., is a systemic immune-mediated vasculitis affecting medium-sized and large-sized arteries. Characteristic findings include headache, jaw claudication, visual loss, and constitutional symptoms (malaise, fever, weight loss, loss of appetite). Localized GCA symptoms are the end-result of vascular insufficiency and tissue ischemia. Temporal artery biopsy (TAB) remains the gold standard for diagnosis. Additional diagnostic tests include blood tests (erythrocyte sedimentation rate, ESR; C-reactive protein, CRP; platelets) and imaging modalities (ultrasound of the arteries; fluorescein angiography, FA; MRI; and positron emission tomography, PET). The mainstay of management includes high-dose corticosteroids, and additional cytotoxic drugs, antitumor necrosis factor monoclonal antibody, and antiplatelet aggregation therapy may be used. The goal of treatment is to prevent ischemic damage and halt progression of visual loss in the affected eye and prevent involvement of the fellow eye. 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.Keywords
This publication has 41 references indexed in Scilit:
- Giant cell arteritisJournal of Clinical Neuroscience, 2009
- Giant Cell Arteritis and Angiogenesis: A ReviewSeminars in Ophthalmology, 2009
- Giant cell arteritisRheumatology International, 2008
- Pathological features of temporal arteries in patients with giant cell arteritis presenting with permanent visual lossAnnals Of The Rheumatic Diseases, 2008
- Giant cell arteritisClinical & Experimental Ophthalmology, 2006
- Reappraisal of the epidemiology of giant cell arteritis in Olmsted County, Minnesota, over a fifty‐year periodArthritis Care & Research, 2004
- The importance of skip lesions in temporal arteritisJournal of Clinical Pathology, 2000
- Trends in incidence and clinical presentation of temporal arteritis in olmsted county, minnesota, 1950–1985Arthritis & Rheumatism, 1988
- The epidemiology of giant cell arteritis including temporal arteritis and polymyalgia rheumaticaArthritis & Rheumatism, 1981
- ARTERITIS OF THE TEMPORAL VESSELSThe Lancet, 1938