Giant-cell arteritis

Systemic vasculitis

GCA usually causes patients to present with headache. The patients are usually in their 50s or older. On questioning they classically show jaw claudication, tongue claudication, scalp tenderness, and a palpable, pulsatile, thickened temporal artery. In reality, few physicians find a palpable temporal artery in patients with this disease.

Patients with probable giant cell arteritis should be treated empirically with high dose steroids to reduce any inflammation. This is because giant cell arteritis has a high risk of causing a blood clot in the temporal artery which can obstruct the opthalmic artery and cause permanent blindness in the affected eye. This can subsequently develop in the other eye in a matter of days.

To confirm the diagnosis, a blood test should be taken to measure ESR. A temporal artery biopsy is necessary to confirm GCA, but the biopsy result is often a false negative, due to skip lesions in the artery.