Gigantcellearteritt

Gigantcellearteritt (giant cell arteritis, GCA), also known as temporal arteritis, is an inflammatory disease of large- and medium-sized arteries. It most commonly affects branches of the carotid artery, including the superficial temporal artery, and can involve the aorta and its major branches. The condition is characterized by granulomatous inflammation with multinucleated giant cells in the arterial wall.

GCA primarily occurs in people over 50 years of age and is more common in women. Typical symptoms include new-onset headache, scalp tenderness, jaw claudication (pain with chewing), visual disturbances that can progress rapidly to vision loss, and constitutional symptoms such as fever, weight loss, and fatigue. Many patients have an associated polymyalgia rheumatica, which causes proximal muscle pain and stiffness.

Diagnosis is based on clinical features, elevated inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), imaging (ultrasound showing a “halo” sign, MRI, or PET for large-vessel involvement), and temporal artery biopsy demonstrating characteristic histology. Prompt diagnosis is important because untreated GCA can cause permanent vision loss and large-vessel complications such as aneurysm.

Immediate high-dose glucocorticoid therapy is the mainstay of treatment to prevent ischemic complications. Tocilizumab, an interleukin-6 receptor inhibitor, and other immunosuppressants are used as steroid-sparing agents in selected patients. Long-term follow-up monitors disease activity, treatment side effects, and vascular complications.