Clinical Features of Temporal (Giant Cell) Arteritis

 

Age: typically >= 50 years

 

Abnormalities in the temporal arteries:

(1) prominent artery

(2) beading along the artery

(3) tenderness to palpation

(4) decreased or absent pulse

(5) skin erythema over the distribution of the artery

 

Ocular abnormalities:

(1) visual loss

(2) ischemic optic neuropathy

(3) signs of retinal ischemia (cotton wool exudates, other)

(4) diplopia

 

Cerebrovascular abnormalities

(1) transient ischemic attack (TIA)

(2) stroke

 

Findings in the head and neck:

(1) headache (especially if of new onset)

(2) scalp necrosis

(3) tongue necrosis

(4) jaw claudication

(5) cranial neuropathy

(6) new onset of pain in the teeth, sinuses or neck

 

Systemic findings:

(1) polymyalgia rheumatica (pain and morning stiffness in neck, shoulders and/or pelvic region)

(2) fever

(3) anorexia with weight loss

(4) fatigue

(5) sweats

(6) malaise

 

Laboratory findings

(1) elevated erythrocyte sedimentation rate (ESR)

(2) anemia of chronic disease

(3) leukocytosis

(4) thrombocytosis

(5) elevated C-reactive protein (CRP)

(6) elevation in other acute phase reactants

(7) abnormal liver function tests

 

Other findings:

(1) aortitis with aortic aneurysm

(2) arteritis involving other arteries, with claudication and reduced pulses in the upper and/or lower extremities

(3) peripheral neuropathy, with paresthesias

(4) arteritis in surgical specimens (gallbladder, other)

(5) Raynaud's phenomenon