Giant cell arteritis


Overview

Giant cell arteritis (GCA) is a disease caused by inflammation in the arteries in the head. It typicall affects older people with average age of 70 and all cases over 50 years old. 

Epidemiology

Age rangeNumber of cases of GCA
50-60
60-70
70-80

Clinical

  • Headaches, fever, weight loss.
  • Tender scalp
  • Jaw pain when chewing

Complications

  • 10% lose vision. Once vision goes it usually cannot be salvaged. Unilateral vision loss is high risk for vision loss in the other eye.

Lab

  • ESR, CRP 

Treatment

Prednisone 60 mg. a day. 

Taper of prednisone 

From Uptodate [2]

taper weekdose (mg/d)
160
250
340
435
530
625
720
815
912.5
1012.5
1110
129
138
147
156
166
175
185
194
204
213
223
232
242
251
261


Actemra


[1] Mayo Clinic

[2] C Salvarani. Treatment of giant cell arteritis. Uptodate.