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Temporal Arteritis

Jenna Paterson Rheumatology Inglés 10 fichas

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  1. 1What is temporal arteritis?Temporal/giant cell arteritis is a systemic vasculitis that can affect both large and medium sized vessels.
  2. 2What condition is temporal arteritis often associated with?Polymyalgia rheumatica
  3. 3Who classically gets temporal arteritis (sex and age)Women >50 years
  4. 4What causes visual symptoms in temporal arteritis?Involvement of the extra cranial branches of the carotid artery (which supplies ophthalmic artery)
  5. 5What are the signs and symptoms of temporal arteritis?- Unilateral, localised headache over temporal area.
    - Tenderness/thickening/nodularity with associated redness of overlying skin.
    - Systemic features
    - Scalp tenderness
    - Intermittent jaw claudication
    - Eye symptoms
    - Neurological features
    - Peripheral arthritis/distal swelling/pitting oedema
  6. 6What are the visual findings in temporal arteritis?- Diplopia
    - Visual field defects
    - Changes to colour vision
    - A feeling of 'shade' covering one eye
    - Typically painless
    Permanent partial or complete loss of vision in one or both eyes occurs in up to 20% of people and is a common early symptom. If untreated, the second eye is likely to become affected within 1-2 weeks (but can be as early as 24h)
    Visual loss is permanent!
  7. 7What are potential signs on fundoscopy of temporal arteritis?Pallor and oedema of the optic disc
    Cotton wool patches
    Small haemorrhages in the retina
  8. 8How can temporal arteritis be diagnosed?- History
    - ESR and CRP elevated
    - Temporal artery USS - Halo sign - thickening of wall of affected vessels.
    - Temporal artery biopsy - may show presence of a mononuclear cell infiltration or granulomatous inflammation usually with multinucleated giant cells
    Other findings - LFTs (mild transaminitis), FBC (normocytic normochromic anaemia)
  9. 9How is temporal arteritis managed?Medical emergency - refer to rheumatology.
    If visual symptoms - oral prednisolone followed by IV methylprednisolone then longer course of oral steroids.
    If no visual symptoms - oral prednisolone
    Then gradual reduction in dose. Follow-up required.
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Rheumatology Fichas sobre Temporal Arteritis , creado por Jenna Paterson el 08/10/2020.
Creado por
Jenna Paterson
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Etiquetas
rheumatology
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