Giant Cell Arteritis (Temporal Arteritis) Questions & Answers

Updated: Sep 10, 2020
  • Author: Mythili Seetharaman, MD; Chief Editor: Herbert S Diamond, MD  more...
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Questions & Answers

Overview

What is giant cell arteritis (GCA) (temporal arteritis)?

Which arteries are typically affected by giant cell arteritis (GCA) (temporal arteritis)?

What are the histopathologic features of giant cell arteritis (GCA) (temporal arteritis)?

What are the risk factors for giant cell arteritis (GCA) (temporal arteritis)?

Are giant cell arteritis (GCA) (temporal arteritis) and polymyalgia rheumatica the same disease?

What are the common signs and symptoms of giant cell arteritis (GCA) (temporal arteritis)?

When should giant cell arteritis (GCA) (temporal arteritis) be suspected?

Does giant cell arteritis (GCA) (temporal arteritis) cause vision impairment?

What are the benefits of early treatment of giant cell arteritis (GCA) (temporal arteritis)?

What is the pathophysiology of giant cell arteritis (GCA) (temporal arteritis)?

What is the primary inflammatory response in giant cell arteritis (GCA) (temporal arteritis)?

What are systemic manifestations of giant cell arteritis (GCA) (temporal arteritis)?

What are the roles of PDGF and VEGF in the pathogenesis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of cell adhesion molecules in the pathogenesis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of platelets in the pathogenesis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of elastin in the pathogenesis of giant cell arteritis (GCA) (temporal arteritis)?

What is the usual pattern of affected arteries in giant cell arteritis (GCA) (temporal arteritis)?

What causes vision loss in giant cell arteritis (GCA) (temporal arteritis)?

Is giant cell arteritis (GCA) (temporal arteritis) a uniform disease?

Are giant cell arteritis (GCA) (temporal arteritis) and polymyalgia rheumatica related disorders?

What is the etiology of giant cell arteritis (GCA) (temporal arteritis)?

Is giant cell arteritis (GCA) (temporal arteritis) a genetic disorder?

What is the role of the immune system in the etiology of giant cell arteritis (GCA) (temporal arteritis)?

What is the incidence of giant cell arteritis (GCA) (temporal arteritis) in the US?

What is the international prevalence of giant cell arteritis (GCA) (temporal arteritis)?

Does giant cell arteritis (GCA) (temporal arteritis) affect racial groups differently?

Is giant cell arteritis (GCA) (temporal arteritis) more common in men or women?

What age groups are most at risk for giant cell arteritis (GCA) (temporal arteritis)?

What is the prognosis of giant cell arteritis (GCA) (temporal arteritis)?

Is complete remission possible in giant cell arteritis (GCA) (temporal arteritis)?

Which risk factors for relapse are associated with long-term steroid therapy for giant cell arteritis (GCA) (temporal arteritis)?

What is the prognosis of untreated giant cell arteritis (GCA) (temporal arteritis)?

Is vision loss caused by giant cell arteritis (GCA) (temporal arteritis) reversible?

What are the risk factors for progressive vision loss in giant cell arteritis (GCA) (temporal arteritis)?

Which nervous system complications may result from giant cell arteritis (GCA) (temporal arteritis)?

What are the possible complications of long-term steroid treatment for giant cell arteritis (GCA) (temporal arteritis)?

What are the possible cardiovascular complications of giant cell arteritis (GCA) (temporal arteritis)?

How does giant cell arteritis (GCA) (temporal arteritis) cause aortic arch syndrome?

How common are aneurysms in patients with giant cell arteritis (GCA) (temporal arteritis)?

How common is central nervous system (CNS) involvement in giant cell arteritis (GCA) (temporal arteritis)?

What education should be given to patients with giant cell arteritis (GCA) (temporal arteritis)?

Presentation

What are the signs and symptoms of giant cell arteritis (GCA) (temporal arteritis)?

Which features of headache suggest giant cell arteritis (GCA) (temporal arteritis)?

Does giant cell arteritis (GCA) (temporal arteritis) cause muscle aches and pain?

Does giant cell arteritis (GCA) cause jaw claudication?

How common are nonspecific symptoms in giant cell arteritis (GCA) (temporal arteritis)?

What are the less common symptoms of giant cell arteritis (GCA) (temporal arteritis)?

What are ocular (ophthalmologic) symptoms of giant cell arteritis (GCA) (temporal arteritis)?

What are cognitive symptoms of giant cell arteritis (GCA) (temporal arteritis)?

Are there audiovestibular symptoms of giant cell arteritis (GCA) (temporal arteritis)?

What joint symptoms suggest giant cell arteritis (GCA) (temporal arteritis)?

What symptoms of giant cell arteritis (GCA) (temporal arteritis) are related to posterior auricular artery involvement?

What symptoms of giant cell arteritis (GCA) (temporal arteritis) are related to large artery involvement?

What is the focus of physical exam in patients with suspected giant cell arteritis (GCA) (temporal arteritis)?

Which ophthalmologic findings suggest giant cell arteritis (GCA) (temporal arteritis)?

Which ophthalmoscopy findings in acute anterior ischemic optic neuropathy (AION) indicate giant cell arteritis (GCA) (temporal arteritis)?

What are vascular ophthalmic presentations of giant cell arteritis (GCA) (temporal arteritis)?

Which ophthalmic findings indicate retrobulbar involvement in giant cell arteritis (GCA) (temporal arteritis)?

What are the neuro-ophthalmic manifestations of giant cell arteritis (GCA) (temporal arteritis)?

How is the oculomotor apparatus involved in giant cell arteritis (GCA) (temporal arteritis)?

DDX

Why would failure to diagnose giant cell arteritis (GCA) (temporal arteritis) be considered a medicolegal risk?

What is polymyalgia rheumatica (PMR)?

What are the typical EMG results in polymyalgia rheumatica (PMR)?

How is polymyalgia rheumatica (PMR) diagnosed?

How often are polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) (temporal arteritis) comorbid?

Which diagnoses should be included in the differential diagnoses of giant cell arteritis (GCA) (temporal arteritis)?

Does amyloidosis affect temporal arteries?

What disorders should be considered in the differential diagnoses of giant cell arteritis (GCA) (temporal arteritis)?

What are the differential diagnoses for Giant Cell Arteritis (Temporal Arteritis)?

Workup

Are the ESR and CRP levels increased in giant cell arteritis (GCA) (temporal arteritis)?

What is the role of MRI in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of acute-phase reactants in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of a CBC count in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of platelet count in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of liver function testing in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of autoreactive antibodies in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of automated visual field testing in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of temporal artery biopsy (TAB) in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of ultrasonography in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

Which imaging studies are useful in the diagnosis of aortic aneurysms in giant cell arteritis (GCA) (temporal arteritis)?

Which imaging studies are performed when aortic or carotid artery disease is suspected in patients with giant cell arteritis (GCA) (temporal arteritis)?

When are CT and MRI performed in the workup of giant cell arteritis (GCA) (temporal arteritis)?

What is the role of PET scanning in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

What are the ACR classification criteria for giant cell arteritis (GCA) (temporal arteritis)?

When should superficial temporal artery biopsy (TAB) be performed in the workup of giant cell arteritis (GCA) (temporal arteritis)?

What are the specificity and sensitivity of temporal artery biopsy (TAB) in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

When is temporal artery biopsy (TAB) performed in suspected giant cell arteritis (GCA) (temporal arteritis)?

What is the likelihood of a positive temporal artery biopsy (TAB) finding after steroid treatment for giant cell arteritis (GCA) (temporal arteritis)?

What are the procedural details of temporal artery biopsy (TAB) for diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

Are bilateral temporal artery biopsies (TAB) required in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

Are giant cells seen on temporal artery biopsy (TAB) clinically significant in giant cell arteritis (GCA) (temporal arteritis)?

What is the role of bilateral temporal artery duplex ultrasonography in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

Does the absence of temporal artery pulses increase the likelihood of a positive temporal artery biopsy (TAB) finding in the workup of giant cell arteritis (GCA) (temporal arteritis)?

What are the risks of temporal artery biopsy (TAB)?

How is a temporal artery biopsy (TAB) performed in the workup of giant cell arteritis (GCA) (temporal arteritis)?

Can ultrasonography be used to diagnose giant cell arteritis (GCA) (temporal arteritis)?

How does steroid treatment affect the presence of the halo on ultrasonography for giant cell arteritis (GCA) (temporal arteritis)?

What does a hypoechoic halo around the temporal artery on a sonogram indicate during a workup of giant cell arteritis (GCA) (temporal arteritis)?

How are cerebral angiography and MRA used in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

Which arteries are most likely to be affected in giant cell arteritis (GCA) (temporal arteritis)?

What is the role of EMG in the diagnosis of giant cell arteritis (GCA) (temporal arteritis)?

Which histopathology findings of the arterial lesion indicate giant cell arteritis (GCA) (temporal arteritis)?

Which histologic findings indicate early giant cell arteritis (GCA) (temporal arteritis)?

Which histologic findings indicate late giant cell arteritis (GCA) (temporal arteritis)?

Treatment

What is the benefit of low-dose aspirin in patients with giant cell arteritis (GCA) (temporal arteritis)?

What is the initial treatment for giant cell arteritis (GCA) (temporal arteritis)?

What is the typical dosage of corticosteroids in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

When are improvements typically seen after initiation of corticosteroid treatment for giant cell arteritis (GCA) (temporal arteritis)?

What are the guidelines for tapering of standard-regimen corticosteroid therapy for giant cell arteritis (GCA) (temporal arteritis)?

What are the guidelines for prophylactic treatment in patients receiving corticosteroids for giant cell arteritis (GCA) (temporal arteritis)?

What is the role of sequential ESR testing in the management of giant cell arteritis (GCA) (temporal arteritis)?

What is the duration of corticosteroid therapy for giant cell arteritis (GCA) (temporal arteritis)?

Which immunosuppressant agents may be used in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

When is hospitalization indicated in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

Is tocilizumab (Actemra) effective in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

Are tumor necrosis factor (TNF) inhibitors effective in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

Which immunosuppressant agents may be effective in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

Are there current clinical trials for giant cell arteritis (GCA) (temporal arteritis) treatments?

Which dietary measures may help prevent diabetes mellitus in patients with giant cell arteritis (GCA) (temporal arteritis)?

Should patients with giant cell arteritis (GCA) (temporal arteritis) restrict physical activity?

When is consultation with a rheumatologist indicated for giant cell arteritis (GCA) (temporal arteritis)?

Which consultations are necessary prior to performing temporal artery biopsy (TAB) for giant cell arteritis (GCA) (temporal arteritis)?

Is consultation with an ophthalmologist or neurologist helpful for giant cell arteritis (GCA) (temporal arteritis)?

What monitoring is required after successful initial management of giant cell arteritis (GCA) (temporal arteritis)?

What are the guidelines for regular follow-up in patients with giant cell arteritis (GCA) (temporal arteritis)?

What are the ACR guidelines for determining risk for osteoporosis in patients with giant cell arteritis (GCA) (temporal arteritis)?

What are possible adverse effects of long-term steroid therapy for giant cell arteritis (GCA) (temporal arteritis)?

Medications

Which drugs are used in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

What is the recommended dosage for corticosteroid therapy for giant cell arteritis (GCA) (temporal arteritis)?

Are drugs other than tocilizumab and corticosteroids used in the treatment of giant cell arteritis (GCA) (temporal arteritis)?

Which medications in the drug class Corticosteroids are used in the treatment of Giant Cell Arteritis (Temporal Arteritis)?

Which medications in the drug class Interleukin Inhibitors are used in the treatment of Giant Cell Arteritis (Temporal Arteritis)?

Which medications in the drug class Immunosuppressant Agents are used in the treatment of Giant Cell Arteritis (Temporal Arteritis)?

Which medications in the drug class Antiplatelet Agents are used in the treatment of Giant Cell Arteritis (Temporal Arteritis)?