Materiały źródłowe

• #1 Giant cell arteritis: epidemiology, diagnosis, and management – PubMed

  https://pubmed.ncbi.nlm.nih.gov/20857242/

  Giant cell arteritis (GCA), also called temporal arteritis, is a vasculitis that affects large and middle-sized blood vessels–with predisposition to the involvement of cranial arteries derived from the carotid artery–in individuals older than 50 years of age. […] Incidence of GCA is higher in white individuals than those of other ethnicities, particularly those of Scandinavian background. […] Giant Cell Arteritis* / epidemiology

• #2

  https://link.springer.com/article/10.1007/s11926-010-0135-9

  Giant cell arteritis (GCA), also called temporal arteritis, is a vasculitis that affects large and middle-sized blood vessels with predisposition to the involvement of cranial arteries derived from the carotid artery in individuals older than 50 years of age. […] Incidence of GCA is higher in white individuals than those of other ethnicities, particularly those of Scandinavian background. […] This review article assessed current information on the epidemiology of GCA and PMR. Different issues, including etiology, incidence, influence of environmental factors and infectious agents, implication of genetic factors, influence of traditional cardiovascular risk factors, the role of biopsy in the incidence of GCA, and the prognosis of GCA and PMR, were discussed. […] Data from Olmsted County, MN, indicated an increase in age at GCA diagnosis that seemed to be related to a significant increase in the incidence of GCA in individuals 70 years of age and older.

• #3 Giant Cell Arteritis (Temporal Arteritis) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459376/

  GCA predominantly affects patients older than 50, with the highest incidence observed in those between 70 and 79. […] In the United States, the lifetime risk of developing GCA is estimated to be approximately 1% for women and 0.5% for men. […] Epidemiological studies also demonstrate a predominance in females, although the role of gender in the pathogenesis of the disease remains unclear. […] Scandinavian countries and individuals of Scandinavian descent exhibit the highest incidence rates, while lower rates are noted in African American, Asian, Arabic, or Japanese populations.

• #4 A meta-analysis of the epidemiology of giant cell arteritis across time and space | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-021-02450-w

  Giant cell arteritis (GCA) is a common large vessel vasculitis in those over age 50 years. This meta-analysis examined the geographical and temporal distribution of the incidence, prevalence, and mortality of GCA. […] The epidemiology of GCA has been extensively studied. The average age of diagnosis has increased from 75 in the 1950s to 79 in the 2000s. GCA has also more common in females at a ratio of 2.5:1. Incidence has consistently been found to be highest in Scandinavia and lowest in Asian countries. […] As the population continues to age, the incidence, prevalence, and mortality of GCA are expected to increase. […] This study demonstrates epidemiological trends in GCA with a comprehensive description of updated global pooled incidence, prevalence, and mortality of GCA. Incidence rates vary significantly between regions and are highest in Scandinavia. Temporally, GCA incidence and mortality decreased, while prevalence remained stable. Latitude does influence incidence but not prevalence or mortality in GCA although the results may be underpowered for comparing prevalence and latitude in GCA.

• #5 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Giant cell arteritis is the most common primary systemic vasculitis in adults. The incidence is negligible in patients less than 50 years old and rises relative to the patients age, with a median age of 75 years. Specifically, the average estimates range between 2.3 per 100,000 cases per year in the sixth decade of life to 44.7 per 100,000 cases per year in patients in their ninth decade. The average age of presentation is 72.5 years for women, and 70.3 years old for men. Furthermore, women are affected between 2 and 6 times more often than men. This increased incidence in women might be explained by the higher proportion of women in the elderly population. When examining the role of race and epidemiology in GCA, white patients of northern European descent have the highest rates (about 30100,000 in Norway) while African, Asian and Arab populations had the lowest rates (1.47100,000 in Japan). Other risk factors may include smoking, low body mass index, early menopause, and relative adrenal hypofunction.

• #6 Temporal Arteritis Pathology: Definition, Epidemiology, Etiology

  https://emedicine.medscape.com/article/1612591-overview

  The incidence of temporal arteritis is 15-25 cases per 100,000 people older than 50 years, with a mean age of 71 years at presentation. Temporal arteritis is the most common systemic vasculitis in adults in Western countries. Women are affected at least twice as often as men. Disease susceptibility is associated with northern European descent, with an incidence of 20 cases per 100,000 individuals. The incidence is considerably lower in Southern Europe and the Mediterranean region and is rare among individuals of African and Asian descent. […] Before the advent of corticosteroids, most patients afflicted with temporal arteritis lost their vision. With current adequate therapy and rapid diagnosis, the incidence of blindness has decreased to 9-25%. However, once vision loss has occurred, it cannot be reversed by corticosteroid therapy.

• #7 Giant Cell Arteritis – Rheumatology Advisor

  https://www.rheumatologyadvisor.com/ddi/giant-cell-arteritis/

  Giant cell arteritis is the most frequent systemic vasculitis involving large and medium vessels, with advanced age being the most significant risk factor. Although the incidence of GCA steadily increases after age 50, it peaks between the ages of 70 and 79, and it rarely affects younger people. Women are 2.5 times more likely than men to develop giant cell arteritis, with a lifetime risk of 1% for women and 0.5% for men. The estimated incidence of giant cell arteritis is approximately 20 per 100,000 population per year, and the condition is more prevalent in North American and Western European populations. A population-based study in Ontario, Canada, found a reasonably consistent incidence of 25 new cases per 100,000 persons aged 9 to 50 years. […] Another study investigating time trends in the incidence and survival of GCA over a 50-year period in Olmsted County, Minnesota, found the age- and sex-adjusted annual incidence rate of giant cell arteritis was 18.8 (95% CI, 15.9-21.6) per 100,000 persons aged 50 years and older. In addition, the overall incidence rate in women was double that in men, and age-specific rates were higher in women of all age groups.

• #8 Clinical manifestations of giant cell arteritis – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-of-giant-cell-arteritis/print

  Giant cell arteritis (GCA) is the most common idiopathic systemic vasculitis. In the United States, the lifetime risk of developing GCA has been estimated at approximately 1 percent in women and 0.5 percent in men. The greatest risk factor for developing GCA is aging. The disease almost never occurs before age 50 years, and its incidence rises steadily thereafter, peaking between the ages of 70 to 79, with over 80 percent of patients older than 70 years of age. One study found the mean age at incidence of GCA to be 76.7 years. In addition to age, ethnicity is a major risk factor for GCA. The highest incidence figures are found in Scandinavian countries and among Americans of Scandinavian descent. In Olmsted County, Minnesota, the annual incidence of GCA was 15 per 100,000 persons over the age of 50, similar to that in Scandinavian countries. This similarity probably reflects shared genetic risk factors, as many of the inhabitants of Olmsted County during the period of study were descended from Scandinavians and northern Europeans. In Southern Europe and Mediterranean countries, incidence rates are lower, with less than 10 per 100,000 persons over the age of 50. GCA is less common in Latin American, Asian, Arab, and African American populations, though formal data on these populations are scant. Autopsy studies suggest that GCA is more frequent than reported in studies of clinically diagnosed cases. A study from Sweden found arteritis in 1.6 percent of 889 postmortem cases in which sections of the temporal artery and two transverse sections of the aorta were made. As with many systemic rheumatic diseases, females are affected more frequently than males, in a ratio of almost 3:1 in populations of Scandinavian descent. The ratio of women to men is lower in Mediterranean countries. Familial aggregation of GCA is not unusual. Most studies have found that life expectancy is not, or is only marginally, reduced in GCA, with the exception of the subset of patients who develop aortic aneurysm or aortic dissection or rupture.

• #9 Giant Cell Arteritis (Temporal Arteritis): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/332483-overview

  The incidence of GCA in Saudi Arabia is probably less than in the United States and Western Europe. In 1998, Bosley and Riley reported only 4 positive biopsy results from 72 temporal artery biopsies performed over a 15-year period in Saudi patients. […] Although existing epidemiologic studies are limited because they have been performed on predominantly white populations, the results of these studies suggest that GCA primarily affects whites, specifically those of northern European descent. […] The female-to-male ratio in GCA is roughly 3.7:1. Smoking increases the risk 6-fold in women. […] Age is the most important risk factor for GCA. The disease is rare in patients younger than 50 years. In those 50 years and older, the incidence increases with age, peaking in the seventh to eighth decade. The age range in one series of 166 biopsy-proven cases was 55-92 years. The median age of onset is 75 years. GCA is the most common systemic vasculitis affecting elderly patients.

• #10 A meta-analysis of the epidemiology of giant cell arteritis across time and space.

  https://www.lenus.ie/handle/10147/631816?show=full

  A meta-analysis of the epidemiology of giant cell arteritis across time and space. […] This meta-analysis examined the geographical and temporal distribution of the incidence, prevalence, and mortality of GCA. […] The pooled incidence of GCA was 10.00 [9.22, 10.78] cases per 100,000 people over 50 years old. […] This incidence was highest in Scandinavia 21.57 [18.90, 24.23], followed by North and South America 10.89 [8.78, 13.00], Europe 7.26 [6.05, 8.47], and Oceania 7.85 [- 1.48, 17.19]. […] Pooled prevalence was 51.74 [42.04, 61.43] cases per 100,000 people over age 50. […] Annual mortality was 20.44 [17.84, 23.03] deaths/1000. […] Mortality generally decreased over the years of publication (p = 0.0008). […] Latitude correlated significantly with incidence (p = 0.0011), but not with prevalence, or mortality. […] GCA incidence varies nearly 3-fold between regions and is highest in Scandinavia but not significantly. […] Mortality may be improving over time.

• #11 Giant Cell Arteritis (Temporal Arteritis): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/332483-overview

  The annual incidence in northern European countries has been reported to be more than 20 cases per 100,000 people over the age of 50 years. A United Kingdom study reported an incidence of 22 per 100,000 in that age group. Scandinavian countries report the highest incidence of GCAup to 32.4 per 100,000 individuals over the age of 50 years. […] The annual incidence in southern European countries has been reported to be less than 12 cases per 100,000 people. In Lugo, Spain, the average annual incidence for the population aged 50 years and older was 10 cases per 100,000 people. […] In Canada, the estimated incidence of biopsy-proven GCA for the population aged older than 50 years is 4.9 to 9.4 cases per 100,000 people. […] A series comprising all adult subjects undergoing autopsy at two hospitals in southern Sweden revealed arteritis in 1.6% of 889 cases, suggesting that GCA may be more common than is clinically apparent.

• #12 Giant Cell Arteritis (Temporal Arteritis): Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/332483-overview

  The reported incidence of GCA ranges from approximately 0.5 to 27 cases per 100,000 people aged 50 years or older. The annual incidence is higher in northern areas of the United States. […] A review from Olmsted County, Minnesota identified 125 cases over a period of 42 years, representing an average annual incidence rate of 17.8 cases per 100,000 population aged 50 years and older and a prevalence of persons with active or remitted GCA of 200 cases per 100,000 population aged 50 years or older. A regular cyclical pattern in incidence over 20 years was noted. […] The prevalence of GCA depends heavily on the number of individuals aged 50 years or older; the mean age of onset is 75 years. Countries with a lower life expectancy have a lower prevalence. Incidence figures reporting biopsy-proven GCA may be lower than those that include clinically diagnosed cases of GCA.

• #13

  https://link.springer.com/article/10.1007/s40674-016-0046-7

  Giant cell arteritis is the most common form of primary systemic vasculitis in people over the age of 50 years. […] Nearly all of the studies evaluating the incidence of GCA are from Europe and USA which may reflect the demographic that is most frequently affected by GCA. […] Age, ethnicity, and sex are consistent risk factors for GCA based on currently available epidemiology studies. […] In nearly all published studies of patients with GCA, women are affected two to four times more often than men. […] GCA almost never occurs in individuals below the age of 50 years. […] The highest incidence rates for GCA are from the Scandinavian countries. […] The estimated incidence of GCA in population-based studies from Olmsted County, Minnesota is similar to that observed in Scandinavian countries.

• #14 AB0694 Giant cell arteritis epidemiology in la reunion: a retrospective cases series | Annals of the Rheumatic Diseases

  https://ard.bmj.com/content/77/Suppl_2/1489.1

  Giant Cell Arteritis (GCA) is the most common vasculitis in people over 50 years, with incidence varying according to geographic location. In Europe, the average incidence is 1030 per 100000 inhabitants over 50 years, whereas in Africa and Asia it is approximately 1.5 per 100000. […] This is the first study to describe GCA in La Runion, and more generally in Indian Ocean. It shows an incidence 412 times lower than in most European countries with white ancestry background. This discrepancy could be explained by the contribution of the various ethnic groups of La Reunion, especially those coming from parts of the world characterised by a lower GCA incidence (Africa, India, South East Asia).

• #15 Giant Cell Arteritis (Temporal Arteritis) | Doctor

  https://patient.info/doctor/giant-cell-arteritis-pro

  Giant cell arteritis occurs in people over the age of 50. Cases in under-50s have been reported, but are exceptionally rare. In some diagnostic criteria, an age above 50 years is considered an absolute requirement for diagnosis. The mean age at onset is approximately 70. […] Giant cell arteritis is 2.5 times more likely to occur in women than in men, with lifetime risk at 1% for women and 0.5% for men. […] It is also more likely to occur in Northern European countries and those of northern Europe ancestry with incidence rate of 20 per 100,000. The incidence of giant cell arteritis is much lower in southern Europe and Mediterranean and quite rare in patients of African and Asian descent. […] The HLA gene most commonly associated with giant cell arteritis in white people is HLA Br1*04. Those with this gene are at higher risk for developing temporal arteritis, higher risk for complications of giant cell arteritis such as visual loss, and higher risk of resistance to glucocorticoids.

• #16 Pathology Outlines – Giant cell arteritis

  https://www.pathologyoutlines.com/topic/heartgiantcellarteritis.html

  Average age of diagnosis is 79 years. […] F:M = 2.5:1. […] Highest incidence in Scandinavia (6 times higher compared to Asia) and lowest in Asia. […] Haplotype variations in certain MHC class II alleles with HLA-DRB1*04 being most common. […] Infectious diseases may lead to immune mediated hypersensitivity and play a role in the pathogenesis of the condition.

• #17 Genetic epidemiology: Giant cell arteritis and polymyalgia rheumatica | Arthritis Research & Therapy | Full Text

  https://arthritis-research.biomedcentral.com/articles/10.1186/ar293

  Giant cell arteritis (GCA) (temporal arteritis) and polymyalgia rheumatica (PMR) are common, frequently related conditions in people generally over 50 years of age. […] GCA is the best example of an association between vasculitis and genes that lie within the HLA class II region. […] Most studies have shown an association with HLA-DRB1*04 alleles. […] The risk of visual complications is also associated with HLA-DRB1*04 alleles. […] Unlike PMR in the context of GCA, which is mostly associated with HLA-DRB1*04, the susceptibility to isolated PMR associated with HLA class II genes varies from one population to another. […] Relapses of PMR, however, have been found to be significantly more common in patients who have the HLA-DRB1*04 allele, and particularly in those carrying the HLA-DRB1*0401 allele.

• #18 Giant cell arteritis: reviewing the advancing diagnostics and management | Eye

  https://www.nature.com/articles/s41433-023-02433-y

  Giant cell arteritis (GCA) is the most common form of vasculitis with a pooled incidence rate of 10 per 100,000 people over the age of 50 years old. The prevalence in England has been shown to be rising, with increased numbers of people being investigated for suspected GCA and increased recognition of sight loss. World-wide by 2050 over 3 million people will be expected to be diagnosed with GCA and half a million are predicted to have permanent vision loss. […] The incidence of GCA is higher in the northern hemisphere, with the highest incidence being recorded in Scandinavia of 21.6 per 100,000 people, as compared to the European incidence being 7.3 per 100,000. Epidemiology publications on the incidence in Olmsted County, USA which have been extrapolated to reflect the incidence in the USA, may have been an overestimate as the County have a higher portion of people with Scandinavian ancestry. Therefore, the geographical distribution is as expected strongly linked with genetic susceptibility. GCA predominantly affects people 50 years of age, with rising prevalence in the context of an aging population and peak in the 7th decade. Women are two and half times more likely to acquire the condition than men.

• #19 Giant Cell Arteritis

  https://practicalneurology.com/articles/2020-may/giant-cell-arteritis

  Giant cell arteritis (GCA), commonly referred to as temporal arteritis, is a chronic, idiopathic granulomatous vasculitis of medium- to large-sized vessels. In countries where GCA is known to occur, it is the most frequent primary vasculitis and may be a medical emergency in some individuals. […] Typically, GCA presents after age 50 and the mean age of onset is 70 years. The prevalence of GCA is highest in people of northern European ancestry, specifically Scandinavian descent. The incidence is much lower in southern Europe and the Mediterranean regions, and GCA is especially rare in Latin America, South Asia, and Africa, although these areas lack large-scale epidemiologic studies such that GCA may not be properly identified. The reported annual incidence ranges from 1.6 to 32.8 cases per 100,000 people age 50 or more. The worldwide occurrence of GCA is expected to increase with the aging population. Some estimates predict that GCA may affect up to 3 million people by 2050, and up to 500,000 will be severely affected, with visual impairment being among the most dangerous morbidities.

• #20 Epidemiology – Primary Care Notebook

  https://primarycarenotebook.com/pages/cardiovascular-medicine/temporal-arteritis/epidemiology

  Temporal arteritis/giant cell arteritis (GCA) almost exclusively affects individuals over 50 years, and is more common in women than men (2.5-3x). […] In the UK both PMR and temporal arteritis were more common in the south than in the north, and both were more commonly diagnosed in the summer months (1). […] Age adjusted annual incidence of GCA in the UK and the USA is estimated at 18-22/100 000 (2). […] GCA and PMR are common in Caucasians, but rare in Asians and Afro-Carribeans. […] incidence has been estimated in over 50s at 7/100 000 of in Italy and 30/100 000 in Denmark. […] a correlation between rates of GCA and the incidence of parvovirus B19 infection has also been shown. […] non-infective environmental agents have also been linked to development of GCA. […] relationship with increasing age led to the suggestion that ageing of the immune system leads to failure of tolerance mechanisms, allowing triggering or perpetuation of a maladaptive inflammatory response.

• #21

  https://link.springer.com/article/10.1007/s40674-016-0046-7

  GCA appears to be rare among non-Caucasian populations in North America. […] The estimated incidence of GCA in Israel is 11.3 per 100,000 people 50 years. […] Given the demographic of patients who are most commonly affected by GCA, genetic factors likely play an important role in susceptibility. […] Few studies have found cyclic pattern or seasonal variations suggesting environmental triggers for GCA, but these remain poorly understood.

• #22 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  The most common systemic complaint of GCA patients is a new onset headache (temporal or occipital), which is present in 90% of cases. Symptoms of polymyalgia rheumatica (PMR) are present in up to 50% of patients. PMR is a more common inflammatory syndrome that seems to share a similar underlying etiology with GCA, as well as a similar demographic of commonly affected patients. […] The diagnosis of GCA should be considered in any patient over the age of 50 with new headaches, acute visual changes, symptoms of polymyalgia rheumatica, unexplained constitutional symptoms, or jaw claudication. Since individual patients with GCA can present with a wide range of symptoms and examination findings, and many of the symptoms may be transient, patients must be questioned directly about symptoms of GCA. In any patient in whom GCA is suspected based on history, examination findings, or an elevated ESR, C-reactive protein or thrombocytosis, a temporal artery biopsy and initiation of corticosteroid treatment should be considered.

• #23 Giant cell arteritis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/giant-cell-arteritis?embed_domain=hackmd.io%2F%40yipuafecsl2jsu8smr5njq%2Fbnjhjgjghjghjghfavicon.icofavicon.ico&lang=us

  Giant cell arteritis is the most common primary systemic vasculitis. It has an incidence of 20 per 100,000 in individuals over the age of 50 years (200 per million persons per year). It typically affects older individuals with patients usually being older than 50 years, with a peak incidence between the ages of 70 and 80 years. There is a recognized female predilection (F:M 2:1). […] Polymyalgia rheumatica: seen concurrently in ~50% of cases.

• #24 Giant cell arteritis – WikEM

  https://wikem.org/wiki/Giant_cell_arteritis

  Systemic vasculitis most commonly involving medium-sized arteries in the carotid circulation, affecting 1% of the population. […] Most frequent primary large-vessel vasculitis in patients over 50. […] Elevated risk in women and Northern European descent. […] „Rule of 50s” can help remember useful points – „temporal arteritis affects patients at least 50 years of age, with a serum ESR 50 mm/hr and is treated with 50mg of prednisone daily.” […] 50% of patients with Giant Cell Arteritis have concomitant Polymylalgia Rheumatica. 15% of patients with Polymyalgia Rheumatica develop Giant Cell Arteritis. […] The role of ESR/CRP is more to rule out (if both normal) rather than to confirm the diagnosis when they are elevated. 4% of patients have normal CRP and ESR with biopsy confirmed diagnosis. […] Needs temporal artery biopsy, although treatment with high dose corticosteroids should be initiated prior to biopsy to avoid permanent vision loss as a result of ophthalmic artery involvement.

• #25 Polymyalgia Rheumatica and Giant Cell Arteritis | AAFP

  https://www.aafp.org/pubs/afp/issues/2006/1101/p1547.html

  Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA; also known as temporal arteritis) are common, interrelated inflammatory disorders that occur predominantly in persons older than 50 years. GCA most commonly involves the temporal artery, but arteries in other parts of the body also can be inflamed. It is the most common primary vasculitis among older persons and can lead to blindness if not diagnosed and treated in a timely manner. About 50 percent of persons with GCA also have PMR, and about 10 percent of those with PMR also have GCA. PMR has a prevalence of one in 133 among persons older than 50, with women two times more likely to be affected than men. GCA is less common, with an annual incidence in persons older than 50 of approximately 18 per 100,000. In both conditions the incidence peaks in those between 70 and 80 years of age, and diagnosis is more common in northern latitudes. […] The most important risk factor for both conditions is older age, and the number of persons at risk in developed countries is expected to double in the next 25 years as the average age of the population increases.

• #26 Temporal Arteritis Pathology: Definition, Epidemiology, Etiology

  https://emedicine.medscape.com/article/1612591-overview

  In a study that evaluated disease flares (relapses and recurrences) in 174 patients with biopsy-proven temporal arteritis, 71 (40.8%) who experienced relapses or recurrences did not show clinical differences compared with the other patients, but they had received corticosteroid therapy for a significantly longer time. The investigators concluded that a chronic inflammatory response manifested by anemia at the time of disease diagnosis may predict the development of disease flares.

• #27 Temporal Arteritis aka Giant Cell Arteritis and Temporal Artery Biopsy Technique | Iowa Head and Neck Protocols

  https://medicine.uiowa.edu/iowaprotocols/temporal-arteritis-aka-giant-cell-arteritis-and-temporal-artery-biopsy-technique

  GCA is the most common vasculitis in individuals or = 50 y.o. occurring in 1-30/100,000 […] Prevalence of GCA is increasing […] Duplex sonography (DS) has been recommended for inclusion as a diagnostic criterion for GCA with reservation of temporal artery biopsy for patients with negative DS results. DS may reveal hypoechoic circumferential arterial wall thickening (halo sign) which disappears after 2-3 weeks of therapy. Two meta-analyses showed unilateral halo sign specificity of 89-91%, sensitivity of 69-75% for GCA; bilateral halo sign specificity of 100%, sensitivity of 43% […] Biopsy confirmation of GCA is important for preventing unnecessary prolonged steroid therapy […] 40-50% of patients relapse during steroid tapering or after steroid withdrawal. Main clinical manifestations of relapse are headaches, PMR, and constitutional symptoms. Chronic relapsing may require indefinite low-dose corticosteroid therapy […] Duplex sonography and PET/CT screening are valid options given high prevalence of aortic and limb arteritis. Beyond the early phase of the disease, GCA may impact patient care given the probably increased incidence of aortic aneurysms.

• #28

  https://bpac.org.nz/bpj/2013/june/arteritis.aspx

  Giant cell arteritis should be strongly considered in older patients presenting with a new type of headache, jaw pain or visual disturbances. […] The most significant risk factors for giant cell arteritis are: Age 50 years, a previous or current diagnosis of polymyalgia rheumatica, female gender, European ethnicity. […] If the findings from the history and examination strongly indicate giant cell arteritis, after considering possible differential diagnoses, urgent treatment and referral should be initiated. […] Urgent referral, i.e. within one week, to hospital for biopsy and an assessment of vision is required. […] The mortality rate of people with giant cell arteritis is not significantly different from the general population. However, the risk of aortic aneurysm is reported to be 17 times greater in people who have had giant cell arteritis, when compared to the general population of the same age and sex, even after timely and successful treatment.

• #29 Giant Cell Arteritis

  https://practicalneurology.com/diseases-diagnoses/headache-pain/giant-cell-arteritis/31658/

  Women are affected by GCA 2 to 6 times more often than men with a total lifetime risk of 1%. Some reports suggest that almost 65% to 70% of cases occur in women. […] The diagnostic criteria for GCA is based on analysis of 214 cases of GCA compared with a sample of 593 patients with other vasculitis types. The traditional criteria, published in 1990, require 3 of 5 criteria and provide sensitivity and specificity of 93.5% and 91.2%, respectively. Those 5 criteria are age 50 or more, new-onset localized headache, temporal artery tenderness or decreased temporal artery pulse, ESR elevated to 50 mm/hour or more, and a consistent biopsy sample. […] A 2017 study assessed the continued validity of the 1990 diagnostic criteria, comparing 1,095 people with primary systemic vasculitis with 415 people who had clinical context-specific comparator conditions and found sensitivity and specificity of the 1990 American College of Radiology (ACR) Criteria for GCA patients of 81.1% and 94.9%, respectively.

• #30 Giant Cell Arteritis Warnings

  https://www.reviewofoptometry.com/article/giant-cell-arteritis-warnings

  Giant cell arteritis (GCA), also known as temporal arteritis, is the most common vasculitis in adults older than 50 years, with an incidence of approximately 18 per 100,000 per year. It affects women four times more often than it affects men and has a prevalence that is highest in caucasians, especially those of Scandinavian or Northern European decent. […] The American College of Rheumatology (ACR) has developed a five-point scoring system with equal weighting for each of the following five parameters for GCA diagnosis: Age more than 50 years. A Westergren ESR greater than 50. Temporal artery tenderness or abnormality on exam. New-onset headache. Positive temporal artery biopsy. […] Therefore, even in cases where the ESR and biopsy results are inconclusive, patients that present with an AAION and have the other risk factors listed here should be treated promptly.

• #31 Orphanet: Giant cell arteritis

  https://www.orpha.net/en/disease/detail/397

  Giant cell arteritis (GCA) is the most common vasculitis in adulthood with an annual incidence of 1/5,000-1/17,000 adults over 50 years old. It is more frequent in populations of northern European background. GCA affects people of more than 50 years of age (median age at diagnosis between 70-75 years old) and occurs twice as frequently in women as in men. […] The diagnosis of GCA is made in individuals over 50 years of age by a combination of characteristic symptoms as outlined above, increased acute phase reactants (erythrocyte sedimentation rate, C-reactive protein or both) and characteristic imaging findings (ultrasound, magnetic resonance imaging, computerized tomography or 18-fluorodeoxyglucose positron emission tomography) of temporal and/or other large arteries depicting inflammatory wall swelling. […] Glucocorticoids (initial dose 40-60mg/day) are highly effective in GCA but prolonged glucocorticoid therapy is often associated with substantial morbidity in the elderly population.

• #32 Giant Cell Arteritis

  https://practicalneurology.com/diseases-diagnoses/headache-pain/giant-cell-arteritis/31658/

  The diagnosis of GCA is made based on history or clinically. There should be a high degree of suspicion in individuals who are more than age 50 and presenting with headache, especially new-onset headache or with visual changes, fevers, jaw claudication, and/or muscle aches. A delay in diagnosis can lead to significant morbidity. […] Blood Tests. The most widely used blood tests to help make the diagnosis are the ESR and CRP, both of which are markers of inflammation, which is typically elevated in arteritis. However, neither is specific to GCA, and both can be elevated with age. […] The standard for diagnosis is histopathology of the temporal artery, which is highly specific and sensitive and can be done in an outpatient setting. The biopsy is usually done on a temporal periauricular artery in the scalp to avoid damaging frontal branches that supply the facial nerve. False-negatives can occur because there may be segmental skip areas within an affected artery.

• #33 A new era for giant cell arteritis | Eye

  https://www.nature.com/articles/s41433-019-0608-7

  The mean diagnostic delay for those with cranial symptoms is 9 weeks and 17.6 weeks for patients presenting without cranial symptoms, due to a combination of multiple factors including delayed presentation, delayed clinical suspicion and delayed referral for specialist assessment and confirmatory diagnostic tests. Public awareness of GCA is low and primary care doctors are faced with the often non-specific nature of many early symptoms of GCA and a high prevalence of similar symptoms in the general consulting population. If GCs are started, but specialist referral is delayed, then the potential for a secure diagnosis is reduced, the clinical signs may have resolved and the diagnostic tests are less likely to be positive with increasing time. […] To address these challenges, in certain centres fast track pathways have been established, providing widely advertised, rapid access to specialist clinical assessment, diagnostic evaluation including vascular US or other diagnostic tests and immediate therapy. Such pathways have been shown to reduce sight loss and have led to significant cost savings due to reduction of inpatient care and reduction in TAB rate. In one fast track centre, sight loss was reduced from 37 to 9%, in another from 27 to 8%. In a third centre, although visual disturbance was equal in the historical and fast track groups, risk of permanent blindness reduced by 88% in the fast track group.

• #34 A new era for giant cell arteritis | Eye

  https://www.nature.com/articles/s41433-019-0608-7

  Giant cell arteritis (GCA) is a granulomatous medium and large-vessel vasculitis. It is the most common form of systemic vasculitis, with an incidence of between 15 and 25 cases per 100,000 persons over 50 years of age. The incidence of GCA increases with age, almost exclusively affecting people 50 years of age or older. Women account for 65-75% of patients; the lifetime risk of GCA in women is 1% compared with 0.5% in men. It mainly affects Caucasians and has a higher incidence in Scandinavian countries and in populations of northern European descent. It is rare in Asian and Black Caribbean/African populations. […] Over the past decade there has been an increased awareness of GCA, leading to an increase in admissions for investigations for suspected GCA. Thus, improved diagnostic pathways, specific tests and targeted management are imperative.

• #35

  https://pjs.zaslavsky.com.ua/index.php/journal/article/view/255

  Giant cell arteritis (GCA) is the most common systemic vasculitis affecting large vessels in subjects over 50 years old. This disease is associated with an increased risk of other inflammatory diseases and vascular conditions. […] The aim of this paper is to perform an analytical review, systematic generalization and discussion of evidence on various epidemiological GCA aspects, modern approaches and methods of its diagnosis as well as risk factors of unfavorable prognosis. […] Incidence and Predictors of Large-Artery Complication (Aortic Aneurysm, Aortic Dissection, and/or Large-Artery Stenosis) in Patients with Giant Cell Arteritis: A Population-Based Study Over 50 Years. […] Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population-based study.

• #36

  https://pjs.zaslavsky.com.ua/index.php/journal/article/view/255

  The relative risk of aortic aneurysm in patient with giant cell arteritis compared with the general population of the UK. […] Large Vessel Involvement in Giant Cell Arteritis: A Population-Based Cohort Study of the Incidence-Trends and Prognosis. […] Diagnostic accuracy of 18F-FDG PET or PET/CT for large vessel vasculitis: A meta-analysis. […] Diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a systematic review and meta-analysis. […] Prognosis of large-vessel giant cell arteritis.

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