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The Diagnosis and Treatment of Giant Cell Arteritis

Please always quote using this URN: urn:nbn:de:bvb:20-opus-131676
  • Background: Giant cell arteritis (GCA) is the most common systemic vasculitis in persons aged 50 and above (incidence, 3.5 per 100 000 per year). It affects cranial arteries, the aorta, and arteries elsewhere in the body, e.g., in the limbs. Methods: We selectively review the pertinent literature, including guidelines and recommendations from Germany and abroad. Results: The typical symptoms of new-onset GCA are bi-temporal headaches, jaw claudiacation, scalp tenderness, visual disturbances, systemic symptoms such as fever and weight loss,Background: Giant cell arteritis (GCA) is the most common systemic vasculitis in persons aged 50 and above (incidence, 3.5 per 100 000 per year). It affects cranial arteries, the aorta, and arteries elsewhere in the body, e.g., in the limbs. Methods: We selectively review the pertinent literature, including guidelines and recommendations from Germany and abroad. Results: The typical symptoms of new-onset GCA are bi-temporal headaches, jaw claudiacation, scalp tenderness, visual disturbances, systemic symptoms such as fever and weight loss, and polymyalgia. The diagnostic assessment comprises laboratory testing (erythrocyte sedimentation rate, C-reactive protein), imaging studies (duplex sonography, high-resolution magnetic resonance imaging, positron-emission tomography), and temporal artery biopsy. The standard treatment is with corticosteroids (adverse effects: diabetes mellitus, osteoporosis, cataract, arterial hypertension). A meta-analysis of three randomized controlled trials led to a recommendation for treatment with methotrexate to lower the recurrence rate and spare steroids. Patients for whom methotrexate is contraindicated or who cannot tolerate the drug can be treated with azathioprine instead. Conclusion: Giant cell arteritis, if untreated, progresses to involve the aorta and its collateral branches, leading to various complications. Late diagnosis and treatment can have serious consequences, including irreversible loss of visual function.show moreshow less

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Metadaten
Author: Thomas Ness, Thorsten A. Bley, Wolfgang A. Schmidt, Peter Lamprecht
URN:urn:nbn:de:bvb:20-opus-131676
Document Type:Journal article
Faculties:Medizinische Fakultät / Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik)
Language:English
Parent Title (English):Deutsches Ärzteblatt International
Year of Completion:2013
Volume:110
Issue:21
Pagenumber:376–86
Source:Deutsches Ärzteblatt International 2013; 110(21): 376–86. DOI: 10.3238/arztebl.2013.0376
DOI:https://doi.org/10.3238/arztebl.2013.0376
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:arteriitis temporal arteriitis; c-reactive protein; complication aortic-aneurysm; corticosteroid treatment; double-blind; erythrocyte sedimentation-rate; large-vessel vasculitis; ocular manifestations; polymyalgia-rheomatica; systemic vasculitides
Release Date:2016/05/23
Licence (German):License LogoDeutsches Urheberrecht