Giant-cell arteritis. Signs and symptoms

Area of Science:

• Rheumatology
• Ophthalmology
• Internal Medicine

Background:

• Giant-cell arteritis (GCA) is a vasculitis primarily affecting older adults.
• It presents with diverse systemic symptoms, including headaches, myalgias, and fever.
• Ocular manifestations, such as anterior ischemic optic neuropathy, can lead to vision loss.

Observation:

• Systemic symptoms include headaches, arthralgias, myalgias, jaw claudication, fever, anemia, anorexia, malaise, and weight loss.
• Major ocular complications are visual loss from anterior ischemic optic neuropathy and diplopia due to ocular muscle ischemia.
• Clinical suspicion is key, prompting laboratory tests and treatment.

Findings:

• Elevated erythrocyte sedimentation rate (ESR) supports the diagnosis.
• High-dose prednisone initiation is recommended upon clinical suspicion confirmed by ESR.
• Temporal artery biopsy is a definitive diagnostic tool, performed after treatment initiation.

Implications:

• Early diagnosis and treatment of GCA are critical to prevent permanent vision loss.
• Physicians must maintain a high index of suspicion for GCA in elderly patients with relevant symptoms.
• Prompt management with corticosteroids can halt disease progression and preserve vision.