ABSTRACT

Giant cell (temporal) arteritis (GCA) is a chronic vasculitis which involves large and medium size vessels. History and physical examination hold the most important place for diagnosis of GCA. New-onset headache is observed in at least two-thirds of GCA patients. Visual loss is the most important complication of disease; and its symptoms may develop slowly within a few weeks or months. Sudden visual loss may develop in some cases with rapid progression. Characteristic laboratory findings of GCA are increased sedimentation rate and CRP which is observed in most patients. Magnetic resonance/angiography, conventional angiography, doppler ultrasonography and positron emission tomography can be used for diagnosis of GCA. Temporal artery biopsy must be performed in all patients suspected of having GCA. If there is any suspicion of GCA, steroid therapy should be started immediately. Adding methotrexate to therapy might be useful in GCA patients who are at high risk for steroid side effects or who have developed steroid effects. While TNF blockers were found to be noneffective in refractory GCA patients, promising results were reported with IL-6 inhibitors.