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General Medicine

Arteritis, Temporal

Jason Assalita, DO, Karl T. Clebak, MD, FAAFP and Munima Nasir, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Technically termed giant cell arteritis (GCA)

  • A chronic, generalized, cellular, and humoral immune-mediated vasculitis of large- and medium-sized vessels, predominantly affecting the ...

DIAGNOSIS

HISTORY

  • Most common presenting symptom is headache (2/3 of patients).

  • Constitutional symptoms (fever, fatigue, weight loss)

  • Any visual disturbances (amaurosis fugax, diplopia)

  • Vision loss (20% o...

TREATMENT

MEDICATION

First Line

Glucocorticoids: 

  • The typical dose of prednisone is between 40 and 60 mg/day (or 1 mg/kg/day), and the dose may be titrated up to relieve symptoms. Steroids should not be ...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Sun avoidance and protection of the head and the face from photodamage may eventually prove to be important preventive measures for TA. 

Patient Monitoring

  • TA is ty...

REFERENCES

1
Borchers AT, Gershwin ME. Giant cell arteritis: a review of classification, pathophysiology, geoepidemiology and treatment. Autoimmun Rev.  2012;11(6–7):A544–A554. [View Abstract on ...

ADDITIONAL READING

Mukhtyar C, Guillevin L, Cid MC, et al. EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis.  2009;68(3):318–323. [View Abstract on OvidMedline]...

SEE ALSO

Depression; Fibromyalgia; Headache, Cluster; Headache, Tension; Polymyalgia Rheumatica; Polymyositis/Dermatomyositis 

CODES

ICD10

  • M31.6 Other giant cell arteritis

  • M31.5 Giant cell arteritis with polymyalgia rheumatica

ICD9

  • 446.5 Giant cell arteritis

SNOMED

  • 400130008 Temporal arteritis (disorder)

  • 414341000 giant cell arterit...

CLINICAL PEARLS

  • Due to the risk of irreversible vision loss, treatment with high-dose steroids (prednisone 60 mg/day) should be started immediately in patients suspected of TA.

  • Temporal artery biopsy i...

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