Giant Cell Arteritis

Giant Cell Arteritis: Drug Therapy

Therapeutic target Avoidance of complications Note: Clinical suspicion of giant cell arteritis is an immediate indication for treatment because of the imminent risk of irreversible visual loss (vision loss)! Therapy recommendations Steroidal anti-inflammatory therapy (anti-inflammatory therapy with glucocorticoids): Giant cell arteritis: prednisolone (glucocorticoids), initially 1 mg/kg bw/d (max 60 mg), then reduction. Amaurosis fugax (transient … Giant Cell Arteritis: Drug Therapy

Giant Cell Arteritis: Diagnostic Tests

Obligatory medical device diagnostics. Color duplex sonography – examination of temporal arteries (temporal arteries), extracranial (“outside the skull“) vessels, and occipital artery, subclavian artery, etc., for signs of inflammation; alternatively, high-resolution magnetic resonance imaging (MRI) may be used [low-echo wall swelling/so-called halo; stenoses (narrowing) may also be used]. Temporal artery biopsy (tissue sampling from the … Giant Cell Arteritis: Diagnostic Tests

Giant Cell Arteritis: Prevention

Prevention factors (protective factors) In giant cell arteritis, a protective effect of acetylsalicylic acid (ASA; dosage 75-100 mg/die) on cardio- and zerovascular events (myocardial infarction/heart attack, apoplexy/stroke) has been described in retrospective studies.

Giant Cell Arteritis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate giant cell arteritis (RZA): due toInvolvement of the cranial vessels (approximately 70% of patients): Severe constant headache (60-90% of those affected); hemifacial or bilateral, especially bitemporal (in the temporal region; tension-type headache) – the initial symptom in 48% of cases; usually responds poorly to analgesics (pain relievers) Pain … Giant Cell Arteritis: Symptoms, Complaints, Signs

Giant Cell Arteritis: Causes

Pathogenesis (disease development) The cause of giant cell arteritis is unknown. Various environmental factors are thought to be triggers. Giant cell arteritis is a systemic segmental giant cell arteritis of the large and medium-sized vessels. The inflammation originates in the adventitia (enveloping layer of connective tissue surrounding the blood and lymphatic vasculature) of the affected … Giant Cell Arteritis: Causes

Giant Cell Arteritis: Therapy

General measures In acute relapse: physical rest and bed rest. In the occurrence of fever: Bed rest and physical rest (even if fever is only slight; if aching limbs and lassitude occur without fever, bed rest and physical rest is also required). Fever below 38.5 °C does not necessarily need to be treated!(Exceptions: Children prone … Giant Cell Arteritis: Therapy

Giant Cell Arteritis: Medical History

Medical history (history of illness) represents an important component in the diagnosis of giant cell arteritis. Family history Are there any diseases in your family that are common? Social anamnesis Current medical history/systemic history (somatic and psychological complaints). What symptoms have you noticed? Are you experiencing any pain? In which area of the body? When … Giant Cell Arteritis: Medical History

Giant Cell Arteritis: Or something else? Differential Diagnosis

Eyes and ocular appendages (H00-H59). Nonarteriitic anterior ischemic optic neuropathy (AION; acute circulatory disturbance of the optic nerve head; imprecisely and colloquially also: “ocular infarction”). Cardiovascular system (I00-I99). Atherosclerosis (arteriosclerosis, hardening of the arteries). Endocarditis (inflammation of the inner lining of the heart) Peripheral arterial occlusive disease (pAVK) – progressive narrowing or occlusion of the … Giant Cell Arteritis: Or something else? Differential Diagnosis

Giant Cell Arteritis: Classification

Giant cell arteritis (RZA) can be classified according to the ACR criteria* : Main criteria Age at onset of disease >50 years New onset of localized headache Localized tenderness or attenuated pulsation of a temporal artery (without atherosclerotic cause) ESR (erythrocyte sedimentation rate) > 50 mm/hour. Evidence of vasculitis by arterial biopsy (vasculitis/vascular inflammation: mononuclear … Giant Cell Arteritis: Classification

Giant Cell Arteritis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure (bilateral blood pressure measurement; arm claudication – weakness/pain of one arm due to aortic arch syndrome; blood pressure side difference; in up to 15% of cases), pulse, body temperature, body weight, body height; furthermore: Inspection (observation). … Giant Cell Arteritis: Examination

Giant Cell Arteritis: Test and Diagnosis

1st order laboratory parameters – obligatory laboratory tests. ESR* (erythrocyte sedimentation rate) [“fall sedimentation rate”; mean values around 90 mm after one hour; normal sedimentation rate only in 1-2% of patients]. CRP* (C-reactive protein) [CRP is more sensitive than ESR; mean values of 90 mg/dL] Small blood count [normochromic normocytic anemia (anemia); leukocytosis (white blood … Giant Cell Arteritis: Test and Diagnosis