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Arteritis, Temporal

Chloe S. Courchesne, MD, Karl T. Clebak, MD, FAAFP and Munima Nasir, MD Reviewed 06/2019
 


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 O...

ADDITIONAL READING

  • De Miguel E, Beltran LM, Monjo I, et al. Atherosclerosis as a potential pitfall in the diagnosis of giant cell arteritis. Rheumatology (Oxford).  2018;57(2):318–321. [View Abst...

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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