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Giant Cell Arteritis (GCA) (Temporal Arteritis), Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Chronic vasculitis of large- and medium-sized vessels that occurs among individuals over 50 yr of age

  • Often referred to as temporal arteritis (TA)

  • Median age of onset is 72

  • Most commonl...

Diagnosis

  • Presence of any 3 or more of the following in patients with vasculitis:

    • ESR >50

    • Age greater than 50 yr

    • New onset of localized headache

    • Tenderness or decreased pulsation of temporal artery

    • New ...

Treatment

Pre-Hospital

  • Acute symptoms may be confused with stroke

  • Initiate appropriate monitoring and oxygen

  • Patients may be hypotensive from 1 of the rare sequelae (aortic dissection, abdominal aortic a...

Follow-Up

Disposition

Admission Criteria

  • Patients with impending vascular complications or acute focal neurologic findings

  • Patients with associated acute visual loss

Discharge Criteria

  • Less symptomatic pat...

Pearls and Pitfalls

  • Permanent visual loss is the most feared complication of GCA

  • Do not delay initiation of steroid therapy to await biopsy if strong clinical suspicion for GCA exists or if visual chan...

Additional Reading

  • Firestein  SG, Budd  RC, Gabriel  SE, et al., eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Saunders Elsevier; 2013.

  • Mackie  SL, Pease  CT. Diagnosis and manage...

Codes

ICD9

446.5 Giant cell arteritis 

ICD10

  • M31.5 Giant cell arteritis with polymyalgia rheumatica

  • M31.6 Other giant cell arteritis

SNOMED

  • 414341000 giant cell arteritis (disorder)

  • 239938009 Giant cell arte...

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