🔬 Other

Giant Cell Arteritis

Also known as: Temporal Arteritis, Horton's Arteritis, Cranial Arteritis

Giant cell arteritis (GCA) is a chronic inflammatory disease of large and medium-sized arteries, predominantly affecting branches of the aortic arch, especially the temporal arteries. It is characterized by granulomatous inflammation and intimal thickening, leading to vessel stenosis or occlusion. GCA typically affects individuals over the age of 50 and is often associated with polymyalgia rheumatica (PMR).

ICD-10: M31.3 Orphanet: 80 OMIM: 612349
👥 40-240 per 100,000 individuals over 50 years old Prevalence
🔬 50 Active Trials

Giant cell arteritis is like when the pipes (blood vessels) in your head get swollen and angry, causing headaches and sometimes vision problems. Doctors give medicine to calm them down.

Signs & Symptoms

  • Headache (often new onset and severe)
  • Temporal artery tenderness or throbbing
  • Jaw claudication (pain with chewing)
  • Visual disturbances (blurred vision, double vision, vision loss)
  • Fever
  • Fatigue
  • Weight loss
  • Scalp tenderness
  • Tongue claudication
  • Polymyalgia rheumatica (PMR) symptoms: pain and stiffness in the shoulders and hips

Treatment Options

MEDICATION FDA Approved

Prednisone (oral corticosteroids)

HIGHLY EFFECTIVE
MEDICATION FDA Approved

Tocilizumab (IL-6 receptor antagonist)

HIGHLY EFFECTIVE Approved 2017
MEDICATION FDA Approved

Aspirin (low-dose)

SUPPORTIVE
MEDICATION FDA Approved

Methotrexate (steroid-sparing agent)

MODERATELY EFFECTIVE
MEDICATION FDA Approved

TNF inhibitors (e.g., Infliximab, Adalimumab)

MODERATELY EFFECTIVE
SUPPORTIVE

Supportive care (calcium and vitamin D supplementation)

SUPPORTIVE

Diagnosis

  • Physical examination
  • Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) blood tests
  • Temporal artery biopsy
  • Imaging studies (e.g., ultrasound, MRI, PET/CT) to assess large vessel involvement

History

Giant cell arteritis was first described by Jonathan Hutchinson in 1890. Horton et al. provided a detailed pathological description in 1932, leading to the alternative name 'Horton's arteritis.' The association with polymyalgia rheumatica was recognized later, highlighting the systemic nature of the disease.

Recent Breakthroughs

2017

FDA Approval of Tocilizumab for Giant Cell Arteritis

Tocilizumab, an interleukin-6 receptor antagonist, was approved by the FDA for the treatment of giant cell arteritis. This marked the first FDA-approved therapy specifically for GCA and provided an alternative to long-term high-dose corticosteroid use.

2021

Advances in Imaging Techniques for GCA Diagnosis

Improved imaging modalities, such as high-resolution vessel wall MRI and PET/CT, have enhanced the ability to diagnose GCA non-invasively, particularly in cases involving large vessel vasculitis.