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Giant cell arteritis (cranial arteritis, polymyalgia rheumatica)

M Mumenthaler

    Journal of Neurology
    |August 25, 1978
    PubMed
    Summary
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    Giant cell arteritis presents with varied symptoms in older adults, often including fever and elevated sedimentation rates. Early corticosteroid treatment is crucial to prevent severe complications like blindness.

    Area of Science:

    • Rheumatology
    • Immunology
    • Geriatrics

    Background:

    • Giant cell arteritis (GCA) is an inflammatory condition affecting elderly individuals, likely linked to immune system dysfunction.
    • Common presenting symptoms include anorexia, weight loss, fever, and an elevated erythrocyte sedimentation rate (ESR) nearing 100 mm/hr.
    • Key clinical manifestations are polymyalgia rheumatica (PMR) and cranial arteritis (CA).

    Purpose of the Study:

    • To describe the clinical spectrum and management of giant cell arteritis in the elderly.
    • To highlight the typical presentations and potential complications of GCA.

    Main Methods:

    • Observational review of clinical symptoms and disease course in elderly patients with GCA.
    • Analysis of common diagnostic markers such as ESR.

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  • Evaluation of treatment outcomes with corticosteroids.

    • Main Results:

    • PMR involves symmetrical shoulder girdle pain; CA presents with temporal headache and visual disturbances in over 50% of cases.
    • Combined PMR and CA presentations are frequent.
    • The disease typically spans 1.5 to 2 years, with rare involvement of other arterial branches.

    Conclusions:

    • Prompt, intensive, and prolonged corticosteroid therapy is essential for managing GCA, primarily to avert ocular complications and blindness.
    • Long-term follow-up is necessary to monitor for relapses and ensure sustained remission.