Question | Answer |
Name some signs and symptoms of temporal arteritis. | 1. new headache
2. jaw claudication
3. visual symptoms (loss of vision)
4. proximal myalgias/arthralgias
5. weight loss
6. malaise
7. fever |
Another name for vasculitis of unknown etiology. | Temporal Arteritis; [AKA Giant Cell Arteritis] |
What kind of arteries does temporal arteritis affect? | Medium to large sized arteries with internal elastic lamina |
What are the preferred sites of TA involvement? | Branches of internal and external carotid arteries, particularly temporal artery |
Who is most effected by temporal arteritis? | It is a disease of the elderly. Rarely found in ages younger than 50, and more common in females. |
Name some clinical findings of temporal arteritis. | 1. temporal artery tenderness or decreased pulsation
2. Visual field cuts
3. ophthalmoplegia (paralysis of occular muscles)
4. ptosis (drooping eyelid)
5. retinal or optic disc ischemia |
Name some diagnostic considerations for temporal arteritis. | Temporal artery biopsy
Labs: CRP, CBC, CMP
ESR-almost always increased, usually =/> 50. (may be normal in 15% of patients) |
Differential diagnoses for temporal arteritis. | 1. other forms of vasculitis, although is usually distinguishable by differences in organ involvement, clinical manifestations, age.
2. Others may include arteriosclerotic dx, malignancy, infection |
Name some treatment options for TA. | 1. High dose prednisone, 40-60mg/day - may require IV solu-medrol in pts with recent blindness, less than 24-36 hrs
2. clinical response is usually rapid
3. ESR normalizes in 2-4 weeks
4. Reduction of daily dose when s/s have resolved / ESR normalized |
True or False? Prognosis with treatment is good. | True |
Risk of death from TA appears to be increased within the first 4 weeks of treatment. True or False? | False. Risk of death appears to be increase within the first 4 MONTHS of treatment. |
Death can occur from vascular complications such as stroke, MI, or ruptured aneurysm? True or False? | True. |
True or False? Remission is maintained after withdrawal of therapy in most cases? | True. |