Giant Cell Arteritis

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Giant cell arteritis (GCA) is the most common idiopathic systemic vasculitis in people ≥50. years of age. Although vascular inflammation may be widespread among medium and large arteries, a tropism for the cranial branches of the aortic arch provides a distinct clinical presentation. Ischemic cranial symptoms in the context of systemic inflammation typically prompt medical evaluation, and biopsy of the superficial temporal artery is the preferred diagnostic modality. Advances in vascular imaging have allowed a greater understanding of the prevalence of extracranial arterial inflammation and its associated sequelae. Particularly concerning is the high morbidity and mortality from aortic aneurysm and dissection. While coronary artery vasculitis can occur in patients with GCA, this is distinctly uncommon. Accelerated atherosclerosis, more clearly defined in other autoimmune conditions, does not appear to be a major contributor to incident coronary artery disease in GCA. Glucocorticoids remain the current first-line treatment for remission induction and maintenance. Preliminary evidence shows promise for biologic medications as glucocorticoid-sparing agents and clinical trials are ongoing.

Original languageEnglish (US)
Title of host publicationThe Heart in Rheumatic, Autoimmune and Inflammatory Diseases
Subtitle of host publicationPathophysiology, Clinical Aspects and Therapeutic Approaches
PublisherElsevier Inc.
Pages367-387
Number of pages21
ISBN (Electronic)9780128032688
ISBN (Print)9780128032671
DOIs
StatePublished - Feb 22 2017

Keywords

  • Accelerated atherosclerosis
  • Aortic aneurysm
  • Aortic dissection
  • Coronary arteritis
  • Giant cell arteritis
  • Heart involvement
  • Treatment

ASJC Scopus subject areas

  • Medicine(all)

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  • Cite this

    Koster, M., Matteson, E. L., & Warrington, K. J. (2017). Giant Cell Arteritis. In The Heart in Rheumatic, Autoimmune and Inflammatory Diseases: Pathophysiology, Clinical Aspects and Therapeutic Approaches (pp. 367-387). Elsevier Inc.. https://doi.org/10.1016/B978-0-12-803267-1.00016-8