An inflammation of the arteries that needs prompt assessment, as early treatment protects against serious complications including sight loss
Giant cell arteritis, or GCA, is a condition in which the larger arteries, often those around the temples and scalp, become inflamed. It mainly affects people over 50 and is closely linked with polymyalgia rheumatica. GCA is important because, if untreated, it can affect vision, so it needs prompt recognition and treatment.
Urgent symptoms: new or sudden changes in your vision, alongside a new headache, scalp tenderness or jaw pain when chewing, need emergency medical assessment without delay. Do not wait for a routine appointment. Contact your GP urgently, call 111, or attend your nearest emergency department.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928).
GCA can develop over days or weeks. Typical features include:
Diagnosis is based on the symptoms, an examination and blood tests that usually show inflammation, supported by further investigations. Because of the risk to vision, treatment is often started promptly when GCA is strongly suspected, before all results are back.
Ultrasound of the affected arteries can help support the diagnosis by showing characteristic changes, and in some cases a biopsy of an artery is appropriate. Because GCA is a serious, sight-threatening condition, Dr Borukhson refers for dedicated specialist imaging, or a biopsy where appropriate, to confirm the diagnosis, and is happy to arrange this promptly. Where GCA is suspected, the priority is always prompt assessment and treatment, which is often started straight away rather than waiting for these results.
GCA responds to steroid (corticosteroid) treatment, which is usually started quickly to protect against complications and then reduced gradually over time under careful review. Prompt steroid treatment is the key to protecting vision and the other arteries that can be affected. Because treatment continues for a while and needs monitoring, ongoing specialist input is valuable.
The plan is tailored to you and kept under regular review, with the dose adjusted as the condition settles.
Giant cell arteritis can affect the eyes and the larger blood vessels, so prompt, coordinated input from more than one specialty can be important. Dr Borukhson practises within a world-renowned tertiary centre, with ready access to consultant colleagues across the other specialties that may be involved in caring for this condition. Where appropriate, she can involve those specialists directly, and bring particularly complex cases to a multidisciplinary team meeting (MDT) with minimal delay. This means that, when more than one area of expertise is needed, your care can be joined up and decisions reached promptly.
The key message with GCA is not to delay. Prompt recognition and treatment greatly reduce the risk of serious complications. If you have the urgent symptoms described above, seek emergency assessment straight away rather than waiting for a routine appointment.
GCA needs prompt assessment. If you have urgent visual symptoms, seek emergency care immediately; otherwise a timely specialist review is important
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