Giant cell arteritis is a systemic vasculitis that can affect any artery, but mostly those are superficial temporal (temporal arteritis), ophthalmic, or vertebral arteries. Typically it affects people older than 60 years.
Irregularly thickened temporal artery
Headache, sore scalp tenderness, pain when chewing, increased sedimentation rate (above 50 mm) and the complex of rheumatic polymyalgia (myalgia, weight loss, anorexia, fever of unknown origin).
Palpation of the temporal artery reveals a painful sensitivity, lack of pulsations, and the knotty thickenings in the artery.
Ocular symptoms: sudden loss of vision, a pale edematous optic disc is seen on the eye background. There may be signs of oculomotor nerve paresis.
Loss of vision is the first sign of temporal arteritis in 10% of cases.
Temporal arteritis is a condition that seriously threatens vision. Therefore, as soon as it is suspected on this disease, steroids should be given immediately and systematically, without waiting for laboratory results.
Usually, a dramatic improvement occurs, while with no therapy the disease leads to severe and permanent vision loss. In 75% of untreated patients the disease affects the other eye, often after only a few hours or days.