Materiały źródłowe

• #1 Giant Cell Arteritis | Arthritis Foundation

  https://www.arthritis.org/diseases/giant-cell-arteritis

  Giant cell arteritis is a disease of the blood vessels, usually in the head/scalp and neck. […] Giant cell arteritis (GCA), or temporal arteritis, is an inflammatory disease affecting the large blood vessels of the scalp, neck and arms. Inflammation causes a narrowing or blockage of the blood vessels, which interrupts blood flow. […] Early symptoms of giant cell arteritis may resemble flu symptoms such as fatigue, loss of appetite and fever. Symptoms specifically related to the inflamed arteries of the head include: Headaches, often severe. Tenderness of the scalp or temples. Double vision. Temporary or sustained vision loss (like having a curtain pulled partly over the eye). Dizziness or problems with coordination and balance. Jaw pain when eating or talking. Persistent sore throat or difficulty swallowing. Occasional chest pain.

• #2 Giant Cell Arteritis : Johns Hopkins Vasculitis Center

  https://www.hopkinsvasculitis.org/types-vasculitis/giant-cell-arteritis/

  GCA commonly causes headaches, joint pain, facial pain, fever, and difficulties with vision, and sometimes permanent visual loss in one or both eyes. […] The most common symptoms of GCA are headache, pain in the shoulders and hips (called polymyalgia rheumatica), pain in the jaw after chewing (called jaw claudication), fever, and blurred vision. Other symptoms can include tenderness of scalp (it hurts to comb the hair), cough, throat pain, tongue pain, weight loss, depression, stroke, or pain in the arms during exercise. […] Blindness the most feared complication can develop if the disease is not treated in a timely fashion. […] GCA requires treatment with prednisone, a type of corticosteroid. Typically, treatment begins with 40-60 mg of prednisone, taken by mouth each day. Most patients improve rapidly and dramatically on this dose, with improvement of most symptoms in 1-3 days.

• #3 Giant Cell Arteritis – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/giant-cell-arteritis

  Symptoms of giant cell arteritis may begin gradually over several weeks or abruptly. […] Patients may present with systemic symptoms such as fever (usually low-grade), fatigue, malaise, unexplained weight loss, and sweats. Some patients are initially diagnosed as having fever of unknown origin. Eventually, most patients develop symptoms related to the affected arteries. […] Severe, sometimes throbbing headache (temporal, occipital, frontal, or diffuse) is the most common symptom. It may be accompanied by scalp pain elicited by touching the scalp or combing the hair. […] Visual disturbances include diplopia, scotomas, ptosis, blurred vision, and loss of vision (which is an ominous sign). Brief periods of partial or complete vision loss (amaurosis fugax) in one eye may be rapidly followed by irreversible loss of vision. If untreated, the other eye may also be affected. However, complete bilateral blindness is uncommon. Vision loss is caused by arteritis of branches of the ophthalmic artery or posterior ciliary arteries, which leads to ischemia of the optic nerve.

• #4 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  The onset of giant cell arteritis (GCA) may be either abrupt or insidious. GCA may begin with constitutional manifestations such as anorexia, fever, malaise, myalgia, night sweat, and weight loss. These prodromal symptoms may occur for a few days and may even stretch out to weeks. […] The most commonly reported symptoms in patients with GCA are as follows: Headache (initial symptom in 33%, present in 72%), Neck, torso, shoulder, and pelvic girdle pain that is consistent with polymyalgia rheumatica (PMR; initial in 25%, present in 58%), Fatigue and malaise (initial in 20%, present in 56%), Jaw claudication (initial in 4%, present in 40%), Fever (initial in 11%, present in 35%). […] The headache of GCA has no pathognomonic features, but typically and most importantly the headache is either new, in a patient without a history of headaches, or of a new type, in a patient with a history of chronic headache. The headache is usually localized to the temporal or occipital area. Less often, the pain may be predominantly occipital or occipitonuchal; occasionally it is diffuse.

• #5 Giant Cell Arteritis

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

  Headache occurs in 70% to 80% of people with giant cell arteritis. […] The presentation of GCA varies depending on which artery is affected. The onset is often insidious with weeks or even months of gradually increasing symptoms that may wax and wane before becoming more severe or permanent. Headaches occur in 70% to 80% of cases. Other symptoms include scalp tenderness, jaw claudication, and vision loss in people with cranial involvement. […] Headache and scalp tenderness tend to be among the first symptoms. Headaches may be described as a dull pain that can be diffuse or localized, most commonly temporal. The pain may also be described as severe, sharp, or burning and can also be localized to the occipital, parietal, or periorbital regions. The pain and scalp tenderness can be resistant to analgesic treatment and so severe that it may interfere with sleep or wearing glasses, owing to scalp tenderness.

• #6

• #7 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  The onset of giant cell arteritis (GCA) may be either abrupt or insidious. GCA may begin with constitutional manifestations such as anorexia, fever, malaise, myalgia, night sweat, and weight loss. These prodromal symptoms may occur for a few days and may even stretch out to weeks. […] The most commonly reported symptoms in patients with GCA are as follows: Headache (initial symptom in 33%, present in 72%), Neck, torso, shoulder, and pelvic girdle pain that is consistent with polymyalgia rheumatica (PMR; initial in 25%, present in 58%), Fatigue and malaise (initial in 20%, present in 56%), Jaw claudication (initial in 4%, present in 40%), Fever (initial in 11%, present in 35%). […] The headache of GCA has no pathognomonic features, but typically and most importantly the headache is either new, in a patient without a history of headaches, or of a new type, in a patient with a history of chronic headache. The headache is usually localized to the temporal or occipital area. Less often, the pain may be predominantly occipital or occipitonuchal; occasionally it is diffuse.

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

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

  Patients with polymyalgia rheumatica should also undergo an evaluation for giant cell arteritis. […] Timely initiation of glucocorticoids is crucial to prevent blindness. […] The spectrum of manifestations in GCA varies, ranging from cranial engagement evidenced by constitutional symptoms, headache, and jaw claudication and a positive temporal artery biopsy to the involvement of large vessels, characterized by nonspecific systemic symptoms and observable vasculitis on imaging. […] Vision loss, a severe complication primarily manifesting as transient monocular visual loss, necessitates early recognition and treatment with high-dose systemic glucocorticoids, possibly combined with interleukin-6 (IL-6) receptor antagonists. […] Clinicians should suspect GCA in any patient older than 50 who presents with a new headache or change in the typical features of their preexisting headache.

• #9 Giant cell arteritis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/giant-cell-arteritis

  Giant cell arteritis frequently causes headaches, scalp tenderness, jaw pain and vision problems. Untreated, it can lead to blindness. […] The most common symptoms of giant cell arteritis are head pain and tenderness often severe that usually affects both temples. Head pain can progressively worsen, come and go, or subside temporarily. […] Generally, signs and symptoms of giant cell arteritis include: Persistent, severe head pain, usually in your temple area, Scalp tenderness, Jaw pain when you chew or open your mouth wide, Fever, Fatigue, Unintended weight loss, Vision loss or double vision, particularly in people who also have jaw pain, Sudden, permanent loss of vision in one eye. […] If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss.

• #10 BBC Two – Trust Me, I’m a Doctor, Series 6, Episode 3 – What is giant cell arteritis and how can I recognise it?

  https://www.bbc.co.uk/programmes/articles/5qMFMJMZW5cZfRfBfwdcFqP/what-is-giant-cell-arteritis-and-how-can-i-recognise-it

  Giant cell arteritis, or GCA, is a condition where arteries in the head and neck become inflamed. […] One of the problems with GCA is that it can come on suddenly and get to a dangerous stage very quickly. However if it is spotted in time it can be treated with steroids and sight can be saved. The key is recognising the red flag symptoms in time. […] Headache headaches in GCA usually develop suddenly and are often extreme. They tend to affect one side of the head and the temples. Patients often described these headaches as being unlike any theyve experienced before. Painkillers are usually ineffective. […] Tenderness the head and scalp can feel very tender, to the extent that it feels sore to brush your hair and in some cases the arteries in the temples are visibly swollen. […] Jaw pain this typically occurs when chewing, talking or swallowing, in some cases pain is felt in the tongue.

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

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

  Giant cell arteritis symptoms include headaches, scalp tenderness and jaw claudication but constitutional symptoms are also common, including malaise, fatigue, weight loss, anorexia and low-grade fever. […] Headaches are typically severe, may be unilateral or bilateral, and are usually located in the temporal area. Patients typically describe the pain as sharp, burning and severe. […] Scalp tenderness occurs in about 50% of people, in particular over the temporal and occipital arteries. […] Intermittent jaw claudication occurs in nearly half of people with giant cell arteritis, causing pain in the jaw muscles (typically over the masseter after minutes of chewing). […] Systemic features such as fever (usually low-grade), fatigue, anorexia, weight loss, and depression are often present.

• #12 Giant cell arteritis – information and resources | RNIB

  https://www.rnib.org.uk/your-eyes/eye-conditions-az/giant-cell-arteritis/

  One of the first signs of GCA is a new onset frequent or constant headache, that can be severe in some case, which may come on suddenly or gradually. It is often at the side of your forehead, at your temples, and it may affect one or both sides of your head. The headache associated with GCA will probably not feel like any headache you’ve had before. […] You may also feel that your temples and scalp are tender to touch, so that combing or brushing your hair feels uncomfortable. This is because the temporal artery is located close to the skin just in front of your ears and continues up to your scalp. […] Some people with GCA also experience pain around their eyes within the eye sockets. […] Another early sign of GCA is pain and tiredness on chewing. This can be a cramp-like pain in your jaw which can make you stop eating. When you stop chewing the pain gets better. You may hear this referred to as jaw claudication and it is due to ischaemia in the muscles that help you to chew. Ischaemia can also cause pain in your tongue, mouth or ear.

• #13

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

  Scalp pain or discomfort occurs in approximately one-quarter of patients with giant cell arteritis. […] Systemic features, including low-grade fever, anorexia and fatigue, are present in approximately half of patients. […] Jaw claudication in the muscles of the tongue and jaw, e.g. while chewing, occurs in approximately one-quarter of people with giant cell arteritis. […] Visual symptoms are less common at initial presentation, but are of critical importance. Symptoms may include transient loss of vision in one eye, blurring and diplopia. […] Relapse of symptoms is relatively common in people with giant cell arteritis, particularly once the dose of prednisone is low, e.g. under 15 mg per day.

• #14 Giant cell arteritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/diagnosis-treatment/drc-20372764

  Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of other common conditions. […] Often, one or both of these arteries are tender, with a reduced pulse and a hard, cordlike feel and appearance. […] If you have giant cell arteritis, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name. […] The main treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. […] You’ll likely begin to feel better within a few days of beginning treatment. […] Some symptoms, particularly headaches, may return during this tapering period. […] When giant cell arteritis is diagnosed and treated early, the prognosis is usually excellent. […] Your symptoms will likely improve quickly after beginning corticosteroid treatment, and your vision isn’t likely to be affected.

• #15 Temporal Arteritis (Giant Cell Arteritis)

  https://patient.info/eye-care/visual-problems/temporal-arteritis-giant-cell-arteritis

  The common symptoms of temporal arteritis (giant cell arteritis) are headache, tenderness over one or both sides of the forehead, and feeling unwell. Other symptoms that may occur include pain in your jaw muscles when you chew which eases when you rest the jaw muscles, and visual loss. […] Symptoms of temporal arteritis can vary, and may depend on which blood vessel/s (artery or arteries) are mainly affected. […] Headache is the common symptom. It occurs in about two thirds of people with giant cell arteritis (GCA). This typically develops suddenly over a day or so but it sometimes develops gradually over several days or weeks. The headache can be one-sided, or on both sides. Typically, it is mainly towards the front and sides of the head. […] Tenderness of the scalp over the temporal arteries is common. You may be able to feel one or both of the inflamed temporal arteries under the skin, or see them in a mirror.

• #16 Clinical manifestations of giant cell arteritis – UpToDate

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

  Clinical manifestations of giant cell arteritis […] The onset of symptoms in giant cell arteritis (GCA) tends to be subacute, but abrupt presentations over a few days can occur. […] Systemic symptoms associated with GCA are frequent and include fever, fatigue, and weight loss. […] Headache is a common presentation of GCA, occurring in more than two-thirds of patients. […] Nearly one-half of GCA patients experience jaw claudication, a symptom that involves mandibular pain or fatigue brought on by mastication and relieved by stopping. […] Transient monocular (and, rarely, binocular) impairment of vision can be an early manifestation of GCA. […] Unquestionably the most feared complication of GCA remains that of permanent loss of vision, which commonly is painless and sudden, may be partial or complete, and may be unilateral or bilateral. […] The clinical consequences of LV GCA comprise aneurysms and dissections of the aorta, particularly the thoracic aorta, as well as stenosis, occlusion, and ectasia of large arteries. […] GCA can affect the subclavian arteries distal to the take-off of the vertebral arteries and extend through the axillary arteries to the proximal brachial arteries. […] Stroke is uncommon in GCA. […] GCA is an unusual cause of ischemic stroke. […] Patients with GCA can present upper respiratory tract symptoms, in particular a nonproductive cough. […] A variety of unusual presentations of GCA have been reported.

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

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

  Other scenarios that warrant suspicion in such patients are jaw claudication, unexplained fever or other constitutional symptoms, abrupt visual disturbance or loss, and signs of vascular abnormalities. […] Jaw claudication, occurring in nearly 50% of patients with GCA, manifests as pain or fatigue in the mandible and occasionally the tongue, triggered by chewing, and typically subsides upon cessation of chewing. […] Approximately 20% to 30% of the patients experience visual disturbances. GCA-associated visual loss can be transient or permanent. […] Transient visual changes typically present as an abrupt partial field defect or as if a curtain covers the field of vision of 1 eye. Permanent vision loss, most often resulting from anterior ischemic optic neuropathy, is painless and sudden, and it can be unilateral, bilateral, partial, or complete. […] Symptoms consistent with polymyalgia rheumatica are the most frequent presentation associated with a relapse of GCA.

• #18 Temporal Arteritis (Giant Cell Arteritis)

  https://patient.info/eye-care/visual-problems/temporal-arteritis-giant-cell-arteritis

  Other symptoms may occur if the arteries going to these parts of the body are inflamed, become narrowed and reduce the blood supply to these areas. These include: […] Pain in the jaw muscles (jaw claudication) while eating or talking. This occurs in nearly half of affected people. The pain eases when you rest the jaw muscles. […] Visual disturbances: permanent partial or complete loss of vision in one or both eyes occurs in up to 1 in 5 affected people and is often an early symptom. People who are affected typically report a feeling of a shade covering one eye, which can progress to total loss of vision. The eye is not painful. If untreated, the second eye is likely to become affected within 1-2 weeks, although it can be affected within 24 hours. Urgent treatment is therefore essential. A temporary loss of vision in one eye or double vision (diplopia) may occur as a 'warning’ symptom before any permanent visual loss. […] Some general symptoms also commonly occur. These include tiredness, depression, night sweats, fever, loss of appetite, and weight loss. These may develop gradually and may be present for weeks or even months before a specific symptom such as headache or visual loss develops.

• #19 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  Jaw claudication is noted as fatigue or discomfort of the jaw muscles during chewing of firm foods such as meat, chewing gum, or prolonged speaking. Jaw claudication is highly predictive of temporal arteritis, and it is a result of ischemia of the maxillary artery supplying the masseter muscles. […] Around 50% of patients with GCA experience visual symptoms over the course of the disease. Initial visual symptoms may be transient and intermittent, typically consisting of unilateral visual blurring or vision loss, often painless, or occasionally diplopia. Alternatively, a partial field defect may progress to complete blindness over days. […] Transient repeated episodes of blurred vision are usually reversible, but sudden irreversible loss of vision may occur, especially if treatment is not started promptly. If GCA remains untreated in patients with unilateral vision loss, the second eye may become affected within 1-2 weeks.

• #20 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  Jaw claudication is noted as fatigue or discomfort of the jaw muscles during chewing of firm foods such as meat, chewing gum, or prolonged speaking. Jaw claudication is highly predictive of temporal arteritis, and it is a result of ischemia of the maxillary artery supplying the masseter muscles. […] Around 50% of patients with GCA experience visual symptoms over the course of the disease. Initial visual symptoms may be transient and intermittent, typically consisting of unilateral visual blurring or vision loss, often painless, or occasionally diplopia. Alternatively, a partial field defect may progress to complete blindness over days. […] Transient repeated episodes of blurred vision are usually reversible, but sudden irreversible loss of vision may occur, especially if treatment is not started promptly. If GCA remains untreated in patients with unilateral vision loss, the second eye may become affected within 1-2 weeks.

• #21

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

  Scalp pain or discomfort occurs in approximately one-quarter of patients with giant cell arteritis. […] Systemic features, including low-grade fever, anorexia and fatigue, are present in approximately half of patients. […] Jaw claudication in the muscles of the tongue and jaw, e.g. while chewing, occurs in approximately one-quarter of people with giant cell arteritis. […] Visual symptoms are less common at initial presentation, but are of critical importance. Symptoms may include transient loss of vision in one eye, blurring and diplopia. […] Relapse of symptoms is relatively common in people with giant cell arteritis, particularly once the dose of prednisone is low, e.g. under 15 mg per day.

• #22 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Giant cell arteritis (GCA) is the most common primary vasculitis in adults. […] In addition to vision loss, patients commonly note associated symptoms such as headache, jaw claudication, diplopia, myalgias, and constitutional symptoms. […] The most commonly feared sequela of GCA is permanent visual loss secondary to arteritic anterior ischemic optic neuropathy (AAION). […] When GCA is suspected, treatment with corticosteroids is indicated on an urgent basis, as further vision loss and fellow eye involvement are usually preventable. […] The most common ocular manifestation in GCA is acute unilateral vision loss, which has been reported in 7-60% of patients with GCA. […] Typically, the vision loss is secondary to optic nerve ischemia (AAION); it is less commonly due to a central retinal artery occlusion.

• #23

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

  Giant cell arteritis usually affects people aged over 50 years, and is only rarely seen in younger people. […] Symptoms of giant cell arteritis include headache, scalp tenderness, jaw claudication or other orofacial pain, neck or shoulder pain, visual disturbances and systemic symptoms, such as sweats, fever and anorexia. […] Visual loss, due to ischaemic optic neuropathy, is an early manifestation and can be a presenting symptom. This occurs in 20-50% of people with giant cell arteritis if they are untreated. […] Giant cell arteritis should be strongly considered in older patients presenting with a new type of headache, jaw pain or visual disturbances. […] Abrupt onset of headache is the most frequent symptom of giant cell arteritis, and will be present in approximately 75% of cases.

• #24 Giant cell arteritis – information and resources | RNIB

  https://www.rnib.org.uk/your-eyes/eye-conditions-az/giant-cell-arteritis/

  You may experience a temporary complete loss of vision in one eye which returns after a while. This is called amaurosis fugax and it is another sign of ischaemia. You may also experience double vision that you haven’t had before because the muscles controlling your eye movements may be affected. […] About 30-50 per cent of people who have untreated GCA will develop a permanent and severe loss of vision in one eye. Without immediate treatment, about a third of these people will develop sight loss in the other eye, often within a week of the first eye. […] Some people lose their sight without having previously noticed any other symptom of GCA. If you experience sudden sight loss, you should go to AE or to a hospital eye casualty department straight away to be seen urgently so that if treatment is needed, it can be given as soon as possible.

• #25 Giant Cell Arteritis – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/giant-cell-arteritis

  Symptoms of giant cell arteritis may begin gradually over several weeks or abruptly. […] Patients may present with systemic symptoms such as fever (usually low-grade), fatigue, malaise, unexplained weight loss, and sweats. Some patients are initially diagnosed as having fever of unknown origin. Eventually, most patients develop symptoms related to the affected arteries. […] Severe, sometimes throbbing headache (temporal, occipital, frontal, or diffuse) is the most common symptom. It may be accompanied by scalp pain elicited by touching the scalp or combing the hair. […] Visual disturbances include diplopia, scotomas, ptosis, blurred vision, and loss of vision (which is an ominous sign). Brief periods of partial or complete vision loss (amaurosis fugax) in one eye may be rapidly followed by irreversible loss of vision. If untreated, the other eye may also be affected. However, complete bilateral blindness is uncommon. Vision loss is caused by arteritis of branches of the ophthalmic artery or posterior ciliary arteries, which leads to ischemia of the optic nerve.

• #26 Giant cell arteritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/symptoms-causes/syc-20372758

  Giant cell arteritis frequently causes headaches, scalp tenderness, jaw pain and vision problems. Untreated, it can lead to blindness. […] The most common symptoms of giant cell arteritis are head pain and tenderness often severe that usually affects both temples. Head pain can progressively worsen, come and go, or subside temporarily. […] Generally, signs and symptoms of giant cell arteritis include: Persistent, severe head pain, usually in your temple area; Scalp tenderness; Jaw pain when you chew or open your mouth wide; Fever; Fatigue; Unintended weight loss; Vision loss or double vision, particularly in people who also have jaw pain; Sudden, permanent loss of vision in one eye. […] If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss.

• #27 Polymyalgia Rheumatica and Giant Cell Arteritis | NIAMS

  https://www.niams.nih.gov/health-topics/polymyalgia-rheumatica-giant-cell-arteritis

  People with polymyalgia rheumatica sometimes have another disorder called giant cell arteritis, which is associated with inflammation of arteries, especially those located on each side of the head, scalp, and the aorta (the large artery that carries blood from the heart) and its main branches. Headaches, scalp tenderness, and jaw pain are common features of giant cell arteritis. […] Symptoms of giant cell arteritis include: […] Headaches and scalp tenderness. These are the most common symptoms. The headache pain may be severe and is usually located in the temple areas. Some people notice tenderness of the scalp, often prior to the onset of headaches. […] Visual disturbances. Many people have episodes of double vision or vision loss in one or both eyes. At first, the visual disturbances may last only a few minutes and resolve on their own. It is important to see a health care provider right away if you develop visual symptoms, because if left untreated, they can lead to permanent vision loss within hours or days.

• #28 Giant Cell Arteritis – Bone, Joint, and Muscle Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/bone-joint-and-muscle-disorders/vasculitic-disorders/giant-cell-arteritis

  Giant cell arteritis is chronic inflammation of large and medium arteries of the head, neck, and upper body. Typically, people have a severe and often throbbing headache, pain in the scalp when they brush their hair, and pain in facial muscles when they chew. Without treatment, blindness can result. Symptoms of giant cell arteritis may begin gradually over several weeks or abruptly. People may have fever and feel tired and generally unwell. They may lose weight unintentionally and sweat more than usual. Symptoms vary, depending on which arteries are affected. Typically, the large arteries to the head are affected, causing a severe, sometimes throbbing headache at the temples or back of the head to develop for the first time. Arteries in the temple may be tender to the touch and feel swollen and bumpy. The scalp may feel painful when touched or when the hair is brushed. Double or blurred vision, large blind spots, sudden blindness in one eye that resolves within a few minutes, or other eye problems may develop. The greatest danger is permanent blindness, which can occur suddenly if the blood supply to the optic nerve is blocked. Complete blindness in both eyes is uncommon if people are treated as soon as the diagnosis is suspected but can occur without treatment. Typically, the jaw muscles hurt and become tired soon after people begin chewing. The tongue may also hurt when eating or speaking. People who experience pain in the jaw and tongue are more likely to have visual problems. Occasionally, blood flow to the brain is blocked, and a stroke occurs. Sometimes inflammation damages the aorta, causing its lining to tear (dissection) or a bulge (aneurysm) to form in its wall. If polymyalgia rheumatica is also present, severe pain and stiffness may occur in the neck, shoulders, and hip that is worse during the night and in the morning.

• #29 Eyes – giant cell arteritis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-giant-cell-arteritis

  Giant cell arteritis is inflammation of the arteries that can cause sudden blindness in one or both eyes. New onset headache and vision loss are the most common symptoms. If the blood vessels servicing the eyes are affected, sudden blindness in one or both eyes can result. This vision loss is usually severe and permanent. The symptoms of giant cell arteritis can include: Sudden and painless blindness in one eye. Sudden and painless blindness in the other eye this may occur one to 10 days later. […] Treatment includes immediate high-dose corticosteroids, which can provide symptom relief within 48 to 72 hours. Treatment aims to stop any more damage to the affected tissues. Quick action is needed to preserve the persons remaining sight.

• #30 Temporal arteritis (Giant Cell Arteritis)

  https://neurologynetwork.com.au/neuro-ophthalmology/giant-cell-arteritis/

  Symptoms can vary, and may depend on which artery or arteries are mainly affected. […] Headache is the common symptom. This typically develops suddenly over a day or so, but it sometimes develops gradually over several days or weeks. It can be one-sided, or on both sides, but typically towards the front and sides of the head. […] Tenderness of the scalp over the temporal arteries is common. […] Visual disturbances: permanent partial or complete loss of vision in one or both eyes occurs in up to 1 in 5 affected people, and is often an early symptom. People who are affected typically report a feeling of a shade covering one eye, which can progress to total blindness. The eye is not painful. If untreated, the second eye is likely to become affected within 1-2 weeks, although it can be affected within 24 hours. Urgent treatment is therefore essential. A temporary loss of vision in one eye, or diplopia (double vision) may occur as a warning symptom before any permanent visual loss.

• #31 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Once permanent visual loss has ensued, it is irreversible. […] Furthermore, some estimates in untreated patients have shown that vision loss in the unaffected eye can ensue within one week of the primary insult. […] Fortunately, the rapid initiation of steroid therapy prior to loss of vision significantly reduces chances of subsequent ocular complications. […] Patients often complain of headache and scalp tenderness. […] These symptoms can be attributed to involvement of the temporal artery, and resultant localized ischemia. […] Jaw claudication, another common symptom of GCA, is due to vascular involvement in the territory of the masticatory muscles. […] Systemic symptoms, such as fevers and malaise, are likely secondary to the release of inflammatory cytokines, such as interleukin-6, during the acute inflammatory phase.

• #32 Giant Cell Arteritis – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/giant-cell-arteritis

  Symptoms of giant cell arteritis may begin gradually over several weeks or abruptly. […] Patients may present with systemic symptoms such as fever (usually low-grade), fatigue, malaise, unexplained weight loss, and sweats. Some patients are initially diagnosed as having fever of unknown origin. Eventually, most patients develop symptoms related to the affected arteries. […] Severe, sometimes throbbing headache (temporal, occipital, frontal, or diffuse) is the most common symptom. It may be accompanied by scalp pain elicited by touching the scalp or combing the hair. […] Visual disturbances include diplopia, scotomas, ptosis, blurred vision, and loss of vision (which is an ominous sign). Brief periods of partial or complete vision loss (amaurosis fugax) in one eye may be rapidly followed by irreversible loss of vision. If untreated, the other eye may also be affected. However, complete bilateral blindness is uncommon. Vision loss is caused by arteritis of branches of the ophthalmic artery or posterior ciliary arteries, which leads to ischemia of the optic nerve.

• #33

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

  Scalp pain or discomfort occurs in approximately one-quarter of patients with giant cell arteritis. […] Systemic features, including low-grade fever, anorexia and fatigue, are present in approximately half of patients. […] Jaw claudication in the muscles of the tongue and jaw, e.g. while chewing, occurs in approximately one-quarter of people with giant cell arteritis. […] Visual symptoms are less common at initial presentation, but are of critical importance. Symptoms may include transient loss of vision in one eye, blurring and diplopia. […] Relapse of symptoms is relatively common in people with giant cell arteritis, particularly once the dose of prednisone is low, e.g. under 15 mg per day.

• #34 Giant cell arteritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/symptoms-causes/syc-20372758

  Giant cell arteritis frequently causes headaches, scalp tenderness, jaw pain and vision problems. Untreated, it can lead to blindness. […] The most common symptoms of giant cell arteritis are head pain and tenderness often severe that usually affects both temples. Head pain can progressively worsen, come and go, or subside temporarily. […] Generally, signs and symptoms of giant cell arteritis include: Persistent, severe head pain, usually in your temple area; Scalp tenderness; Jaw pain when you chew or open your mouth wide; Fever; Fatigue; Unintended weight loss; Vision loss or double vision, particularly in people who also have jaw pain; Sudden, permanent loss of vision in one eye. […] If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss.

• #35 Giant Cell Arteritis – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/giant-cell-arteritis

  Symptoms of giant cell arteritis may begin gradually over several weeks or abruptly. […] Patients may present with systemic symptoms such as fever (usually low-grade), fatigue, malaise, unexplained weight loss, and sweats. Some patients are initially diagnosed as having fever of unknown origin. Eventually, most patients develop symptoms related to the affected arteries. […] Severe, sometimes throbbing headache (temporal, occipital, frontal, or diffuse) is the most common symptom. It may be accompanied by scalp pain elicited by touching the scalp or combing the hair. […] Visual disturbances include diplopia, scotomas, ptosis, blurred vision, and loss of vision (which is an ominous sign). Brief periods of partial or complete vision loss (amaurosis fugax) in one eye may be rapidly followed by irreversible loss of vision. If untreated, the other eye may also be affected. However, complete bilateral blindness is uncommon. Vision loss is caused by arteritis of branches of the ophthalmic artery or posterior ciliary arteries, which leads to ischemia of the optic nerve.

• #36 BBC Two – Trust Me, I’m a Doctor, Series 6, Episode 3 – What is giant cell arteritis and how can I recognise it?

  https://www.bbc.co.uk/programmes/articles/5qMFMJMZW5cZfRfBfwdcFqP/what-is-giant-cell-arteritis-and-how-can-i-recognise-it

  Drenching night and day sweats, weight loss, tiredness, lethargy and aches and pains often pain occurs in the neck and shoulders. […] Vision problems these affect 1 in 5 people with GCA and can affect one or both eyes. Some patients have described the visual disturbance as being like having a shade covering their eye. Many people also experience episodes of double vision or blurred vision and sometimes sight vanishes entirely. […] The above symptoms usually develop quickly but some other symptoms can also start weeks or months earlier, such as weight loss, sweats, tiredness, mild fever, loss of appetite and depression.

• #37 Giant Cell Arteritis | Arthritis Foundation

  https://www.arthritis.org/diseases/giant-cell-arteritis

  Giant cell arteritis is a disease of the blood vessels, usually in the head/scalp and neck. […] Giant cell arteritis (GCA), or temporal arteritis, is an inflammatory disease affecting the large blood vessels of the scalp, neck and arms. Inflammation causes a narrowing or blockage of the blood vessels, which interrupts blood flow. […] Early symptoms of giant cell arteritis may resemble flu symptoms such as fatigue, loss of appetite and fever. Symptoms specifically related to the inflamed arteries of the head include: Headaches, often severe. Tenderness of the scalp or temples. Double vision. Temporary or sustained vision loss (like having a curtain pulled partly over the eye). Dizziness or problems with coordination and balance. Jaw pain when eating or talking. Persistent sore throat or difficulty swallowing. Occasional chest pain.

• #38 Giant cell arteritis – information and resources | RNIB

  https://www.rnib.org.uk/your-eyes/eye-conditions-az/giant-cell-arteritis/

  Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of other common conditions. […] Some people with GCA also experience more general symptoms such as weight loss, tiredness, flu-like symptoms, night sweats, fever and depression. […] Usually, people have some symptoms of GCA before their sight is affected, so it’s very important to see your GP straight away if you are concerned that you might have a problem.

• #39 BBC Two – Trust Me, I’m a Doctor, Series 6, Episode 3 – What is giant cell arteritis and how can I recognise it?

  https://www.bbc.co.uk/programmes/articles/5qMFMJMZW5cZfRfBfwdcFqP/what-is-giant-cell-arteritis-and-how-can-i-recognise-it

  Drenching night and day sweats, weight loss, tiredness, lethargy and aches and pains often pain occurs in the neck and shoulders. […] Vision problems these affect 1 in 5 people with GCA and can affect one or both eyes. Some patients have described the visual disturbance as being like having a shade covering their eye. Many people also experience episodes of double vision or blurred vision and sometimes sight vanishes entirely. […] The above symptoms usually develop quickly but some other symptoms can also start weeks or months earlier, such as weight loss, sweats, tiredness, mild fever, loss of appetite and depression.

• #40

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

  Scalp pain or discomfort occurs in approximately one-quarter of patients with giant cell arteritis. […] Systemic features, including low-grade fever, anorexia and fatigue, are present in approximately half of patients. […] Jaw claudication in the muscles of the tongue and jaw, e.g. while chewing, occurs in approximately one-quarter of people with giant cell arteritis. […] Visual symptoms are less common at initial presentation, but are of critical importance. Symptoms may include transient loss of vision in one eye, blurring and diplopia. […] Relapse of symptoms is relatively common in people with giant cell arteritis, particularly once the dose of prednisone is low, e.g. under 15 mg per day.

• #41 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #42 Giant cell arteritis | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/giant-cell-arteritis

  Giant cell arteritis frequently causes headaches, scalp tenderness, jaw pain and vision problems. Untreated, it can lead to blindness. […] The most common symptoms of giant cell arteritis are head pain and tenderness often severe that usually affects both temples. Head pain can progressively worsen, come and go, or subside temporarily. […] Generally, signs and symptoms of giant cell arteritis include: Persistent, severe head pain, usually in your temple area, Scalp tenderness, Jaw pain when you chew or open your mouth wide, Fever, Fatigue, Unintended weight loss, Vision loss or double vision, particularly in people who also have jaw pain, Sudden, permanent loss of vision in one eye. […] Pain and stiffness in the neck, shoulders or hips are common symptoms of a related disorder, polymyalgia rheumatica. About 50 percent of people with giant cell arteritis also have polymyalgia rheumatica. […] If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss.

• #43 Giant Cell Arteritis | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/giantcellarteritis/

  Giant cell arteritis is an inflammatory condition that can cause vision loss, double vision, fever, new persistent headaches, scalp tenderness, and jaw pain with chewing. […] Vision loss in one or both eyes occurs in 20-50% of patients. Approximately 1/3 of patients who lose vision from GCA experience transient vision loss in one eye 7-10 days prior to the permanent vision loss. If not recognized and treated promptly, the second eye will lose vision within 7-10 days in 70% of cases. Vision loss is typically severe and almost always irreversible, even with treatment. For this reason, early diagnosis and prompt treatment are imperative. Intermittent or sustained double vision can also be a warning sign of impending visual loss. […] The most common initial GCA symptom is a new persistent headache, which is present in 40-90% of patients. Scalp tenderness is also common and often noticed when brushing or washing hair, or sleeping on one side of the head. Less common, but important symptoms include pain and fatigue in the jaw, ear, tongue, throat, or neck while chewing or swallowing, especially after doing so for a few minutes. These symptoms, called jaw claudication, are very concerning for GCA and should be taken very seriously.

• #44 Temporal Arteritis: Symptoms, Treatments, and Causes

  https://www.healthline.com/health/temporal-arteritis

  The symptoms of temporal arteritis can include: […] Sudden, painless visual disturbance, including temporary or permanent loss of vision in one eye or rarely both eyes […] new headache or change from baseline headache […] fatigue […] weakness […] loss of appetite […] jaw pain that occurs with chewing or talking […] cough […] tongue pain […] sore throat or hoarse voice […] numbness, tingling, weakness, or coolness of the arms or legs […] fever […] unintentional weight loss […] shoulder pain, hip pain, and stiffness […] tenderness in the scalp and temple areas often noticed after brushing your hair. […] These symptoms can also occur due to other conditions, and symptoms can vary in intensity, duration, and quality. […] If you have symptoms or a diagnosis of temporal arteritis, it’s important to get treatment immediately to prevent serious complications. Visual loss or blindness is the most serious complication. Other complications can include: inflammation and damage to other blood vessels in the body, development of aneurysms, including aortic aneurysms and a more rarely occurring aortic dissection, eye muscle weakness, stroke. […] Your outlook for temporal arteritis will depend on how quickly you’re diagnosed and start treatment. Untreated temporal arteritis can cause serious damage to the blood vessels in your body, and in some cases, it can be life threatening.

• #45 Clinical manifestations of giant cell arteritis – UpToDate

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

  Clinical manifestations of giant cell arteritis […] The onset of symptoms in giant cell arteritis (GCA) tends to be subacute, but abrupt presentations over a few days can occur. […] Systemic symptoms associated with GCA are frequent and include fever, fatigue, and weight loss. […] Headache is a common presentation of GCA, occurring in more than two-thirds of patients. […] Nearly one-half of GCA patients experience jaw claudication, a symptom that involves mandibular pain or fatigue brought on by mastication and relieved by stopping. […] Transient monocular (and, rarely, binocular) impairment of vision can be an early manifestation of GCA. […] Unquestionably the most feared complication of GCA remains that of permanent loss of vision, which commonly is painless and sudden, may be partial or complete, and may be unilateral or bilateral. […] The clinical consequences of LV GCA comprise aneurysms and dissections of the aorta, particularly the thoracic aorta, as well as stenosis, occlusion, and ectasia of large arteries. […] GCA can affect the subclavian arteries distal to the take-off of the vertebral arteries and extend through the axillary arteries to the proximal brachial arteries. […] Stroke is uncommon in GCA. […] GCA is an unusual cause of ischemic stroke. […] Patients with GCA can present upper respiratory tract symptoms, in particular a nonproductive cough. […] A variety of unusual presentations of GCA have been reported.

• #46 Giant Cell Arteritis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/g/giant-cell-arteritis.html

  Symptoms of GCA can vary depending on the location of the inflammation and may include: […] Loss of vision […] Double vision […] Fever […] Unexplained weight loss […] Dizziness […] Difficulty with coordination […] Difficulty with balance.

• #47 Giant Cell Arteritis : Johns Hopkins Vasculitis Center

  https://www.hopkinsvasculitis.org/types-vasculitis/giant-cell-arteritis/

  GCA commonly causes headaches, joint pain, facial pain, fever, and difficulties with vision, and sometimes permanent visual loss in one or both eyes. […] The most common symptoms of GCA are headache, pain in the shoulders and hips (called polymyalgia rheumatica), pain in the jaw after chewing (called jaw claudication), fever, and blurred vision. Other symptoms can include tenderness of scalp (it hurts to comb the hair), cough, throat pain, tongue pain, weight loss, depression, stroke, or pain in the arms during exercise. […] Blindness the most feared complication can develop if the disease is not treated in a timely fashion. […] GCA requires treatment with prednisone, a type of corticosteroid. Typically, treatment begins with 40-60 mg of prednisone, taken by mouth each day. Most patients improve rapidly and dramatically on this dose, with improvement of most symptoms in 1-3 days.

• #48 Giant Cell Arteritis – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/giant-cell-arteritis

  Intermittent claudication (ischemic muscle pain) may occur in jaw muscles and muscles of the tongue or extremities. Jaw claudication is noted especially when firm foods are chewed. Jaw claudication and diplopia are associated with a higher risk of blindness. […] Neurologic manifestations, such as strokes and transient ischemic attacks, can result when the carotid or vertebrobasilar arteries or branches are narrowed or occluded. […] Thoracic aortic aneurysms and dissection of the aorta are serious, often late complications of aortitis and may progress in the absence of other symptoms.

• #49 Quick Facts:Giant Cell Arteritis – MSD Manual Consumer Version

  https://www.msdmanuals.com/home/quick-facts-bone-joint-and-muscle-disorders/vasculitic-disorders/giant-cell-arteritis

  Giant cell arteritis usually involves the large arteries that go from your heart to your neck and head […] You may have severe headaches, pain in your scalp when you brush your hair, and pain in your jaw when you chew food […] Giant cell arteritis may lead to blindness or stroke if you dont get treatment right away […] Symptoms of giant cell arteritis may start suddenly or come on slowly over several weeks […] You may have general symptoms such as fever, sweating, and feeling tired and ill. About half of people have stiff, painful muscles in their neck, shoulders, and hips. The pain and stiffness are worse in the morning, similar to what happens in polymyalgia rheumatica […] Specific symptoms depend on which artery is affected and can include: Severe, throbbing headache in your temples or the back of your head […] Blurry vision, double vision, sudden blindness in one eye […] Jaw pain when chewing […] A stroke […] Rarely, giant cell arteritis affects your aorta, the main artery coming out of your heart. You may get chest pain caused by an aortic aneurysm or aortic dissection.

• #50 Giant Cell Arteritis – Musculoskeletal and Connective Tissue Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/vasculitis/giant-cell-arteritis

  Symptoms of giant cell arteritis may begin gradually over several weeks or abruptly. […] Patients may present with systemic symptoms such as fever (usually low-grade), fatigue, malaise, unexplained weight loss, and sweats. Some patients are initially diagnosed as having fever of unknown origin. Eventually, most patients develop symptoms related to the affected arteries. […] Severe, sometimes throbbing headache (temporal, occipital, frontal, or diffuse) is the most common symptom. It may be accompanied by scalp pain elicited by touching the scalp or combing the hair. […] Visual disturbances include diplopia, scotomas, ptosis, blurred vision, and loss of vision (which is an ominous sign). Brief periods of partial or complete vision loss (amaurosis fugax) in one eye may be rapidly followed by irreversible loss of vision. If untreated, the other eye may also be affected. However, complete bilateral blindness is uncommon. Vision loss is caused by arteritis of branches of the ophthalmic artery or posterior ciliary arteries, which leads to ischemia of the optic nerve.

• #51 Polymyalgia Rheumatica and Giant Cell Arteritis | NIAMS

  https://www.niams.nih.gov/health-topics/polymyalgia-rheumatica-giant-cell-arteritis

  In most people, symptoms of giant cell arteritis develop over the course of weeks or months, but in some cases the onset is more abrupt. Some people may have only large artery involvement (such as the aorta) and not have any symptoms in the head or scalp; these people may experience flu-like symptoms or no symptoms at all.

• #52 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Giant cell arteritis (GCA) is the most common primary vasculitis in adults. […] In addition to vision loss, patients commonly note associated symptoms such as headache, jaw claudication, diplopia, myalgias, and constitutional symptoms. […] The most commonly feared sequela of GCA is permanent visual loss secondary to arteritic anterior ischemic optic neuropathy (AAION). […] When GCA is suspected, treatment with corticosteroids is indicated on an urgent basis, as further vision loss and fellow eye involvement are usually preventable. […] The most common ocular manifestation in GCA is acute unilateral vision loss, which has been reported in 7-60% of patients with GCA. […] Typically, the vision loss is secondary to optic nerve ischemia (AAION); it is less commonly due to a central retinal artery occlusion.

• #53

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

  Giant cell arteritis usually affects people aged over 50 years, and is only rarely seen in younger people. […] Symptoms of giant cell arteritis include headache, scalp tenderness, jaw claudication or other orofacial pain, neck or shoulder pain, visual disturbances and systemic symptoms, such as sweats, fever and anorexia. […] Visual loss, due to ischaemic optic neuropathy, is an early manifestation and can be a presenting symptom. This occurs in 20-50% of people with giant cell arteritis if they are untreated. […] Giant cell arteritis should be strongly considered in older patients presenting with a new type of headache, jaw pain or visual disturbances. […] Abrupt onset of headache is the most frequent symptom of giant cell arteritis, and will be present in approximately 75% of cases.

• #54 Giant Cell Arteritis | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/giantcellarteritis/

  Giant cell arteritis is an inflammatory condition that can cause vision loss, double vision, fever, new persistent headaches, scalp tenderness, and jaw pain with chewing. […] Vision loss in one or both eyes occurs in 20-50% of patients. Approximately 1/3 of patients who lose vision from GCA experience transient vision loss in one eye 7-10 days prior to the permanent vision loss. If not recognized and treated promptly, the second eye will lose vision within 7-10 days in 70% of cases. Vision loss is typically severe and almost always irreversible, even with treatment. For this reason, early diagnosis and prompt treatment are imperative. Intermittent or sustained double vision can also be a warning sign of impending visual loss. […] The most common initial GCA symptom is a new persistent headache, which is present in 40-90% of patients. Scalp tenderness is also common and often noticed when brushing or washing hair, or sleeping on one side of the head. Less common, but important symptoms include pain and fatigue in the jaw, ear, tongue, throat, or neck while chewing or swallowing, especially after doing so for a few minutes. These symptoms, called jaw claudication, are very concerning for GCA and should be taken very seriously.

• #55 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  Jaw claudication is noted as fatigue or discomfort of the jaw muscles during chewing of firm foods such as meat, chewing gum, or prolonged speaking. Jaw claudication is highly predictive of temporal arteritis, and it is a result of ischemia of the maxillary artery supplying the masseter muscles. […] Around 50% of patients with GCA experience visual symptoms over the course of the disease. Initial visual symptoms may be transient and intermittent, typically consisting of unilateral visual blurring or vision loss, often painless, or occasionally diplopia. Alternatively, a partial field defect may progress to complete blindness over days. […] Transient repeated episodes of blurred vision are usually reversible, but sudden irreversible loss of vision may occur, especially if treatment is not started promptly. If GCA remains untreated in patients with unilateral vision loss, the second eye may become affected within 1-2 weeks.

• #56 Temporal arteritis (Giant Cell Arteritis)

  https://neurologynetwork.com.au/neuro-ophthalmology/giant-cell-arteritis/

  Symptoms can vary, and may depend on which artery or arteries are mainly affected. […] Headache is the common symptom. This typically develops suddenly over a day or so, but it sometimes develops gradually over several days or weeks. It can be one-sided, or on both sides, but typically towards the front and sides of the head. […] Tenderness of the scalp over the temporal arteries is common. […] Visual disturbances: permanent partial or complete loss of vision in one or both eyes occurs in up to 1 in 5 affected people, and is often an early symptom. People who are affected typically report a feeling of a shade covering one eye, which can progress to total blindness. The eye is not painful. If untreated, the second eye is likely to become affected within 1-2 weeks, although it can be affected within 24 hours. Urgent treatment is therefore essential. A temporary loss of vision in one eye, or diplopia (double vision) may occur as a warning symptom before any permanent visual loss.

• #57 Giant Cell Arteritis | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/giantcellarteritis/

  Giant cell arteritis is an inflammatory condition that can cause vision loss, double vision, fever, new persistent headaches, scalp tenderness, and jaw pain with chewing. […] Vision loss in one or both eyes occurs in 20-50% of patients. Approximately 1/3 of patients who lose vision from GCA experience transient vision loss in one eye 7-10 days prior to the permanent vision loss. If not recognized and treated promptly, the second eye will lose vision within 7-10 days in 70% of cases. Vision loss is typically severe and almost always irreversible, even with treatment. For this reason, early diagnosis and prompt treatment are imperative. Intermittent or sustained double vision can also be a warning sign of impending visual loss. […] The most common initial GCA symptom is a new persistent headache, which is present in 40-90% of patients. Scalp tenderness is also common and often noticed when brushing or washing hair, or sleeping on one side of the head. Less common, but important symptoms include pain and fatigue in the jaw, ear, tongue, throat, or neck while chewing or swallowing, especially after doing so for a few minutes. These symptoms, called jaw claudication, are very concerning for GCA and should be taken very seriously.

• #58 Giant Cell Arteritis (Temporal Arteritis): Signs & Treatment

  https://my.clevelandclinic.org/health/diseases/temporal-arteritis-giant-cell-arteritis

  Giant cell arteritis is a kind of vasculitis, which is inflammation of your blood vessels. The most common symptom of giant cell arteritis is a throbbing headache. […] The most common symptom of giant cell arteritis is a throbbing, continuous headache on one or both sides of your forehead. Other symptoms may include: Tenderness at your scalp or temples, Jaw pain that becomes worse with chewing, Vision problems, like double vision, blurry vision or temporary vision loss, Fatigue, Fever, Loss of appetite or weight loss, Muscle aches in your upper arms and shoulders, hips, upper thighs, lower back and buttocks. […] If not diagnosed and treated quickly, giant cell arteritis can cause: Damage to your eyesight, including sudden vision loss or blindness in one or both eyes, Damage to your blood vessels, like an aneurysm, Other disorders, including stroke or transient ischemic attacks. […] Without early treatment, the GCA can lead to permanent vision loss, and life-threatening complications, such as aneurysms and stroke. It’s important to see your healthcare provider right away if you experience any of the symptoms associated with GCA.

• #59 Giant cell arteritis (GCA) | Causes, symptoms, treatments

  https://versusarthritis.org/about-arthritis/conditions/giant-cell-arteritis-gca/

  Less commonly, GCA can affect other large blood vessels that could lead to pain when using the arm muscles or in the calves when walking. […] Rarely, if someone has had GCA or PMR for a long time, they may develop aneurysms. This is when artery walls increase in size and can bulge and become weak.

• #60 Giant Cell Arteritis: Causes, Symptoms & Treatment | Tampa General Hospital

  https://www.tgh.org/institutes-and-services/conditions/giant-cell-arteritis

  Giant cell arteritis can lead to serious complications including blindness, aortic aneurysms and strokes if left untreated. […] The symptoms of giant cell arteritis can vary depending on where the resulting inflammation is located within the body. For example, when giant cell arteritis causes the arteries within the temples to become inflamed, it can produce severe pain and tenderness in that area. This pain is often described as a throbbing headache, and it may be intermittent or progressively worsen. […] Other common symptoms of giant cell arteritis include fever, fatigue, muscle aches, reduced appetite, and unexplained weight loss. […] Giant cell arteritis always requires immediate medical care, and early treatment can improve a persons chances of preserving their vision. […] Failing to treat giant cell arteritis can lead to serious complications such as blindness, aortic aneurysms, and strokes.

• #61 Giant Cell Arteritis – UF Health

  https://ufhealth.org/conditions-and-treatments/giant-cell-arteritis

  Some common symptoms of this problem are: […] New throbbing headache on one side of the head or the back of the head […] Tenderness when touching the scalp […] Other symptoms may include: […] Jaw pain that occurs when chewing (called jaw claudication) […] Pain in the arm after using it […] Muscle aches […] Pain and stiffness in the neck, upper arms, shoulder, and hips (polymyalgia rheumatica) […] Weakness, excessive tiredness […] Fever […] General ill feeling […] Problems with eyesight may occur, and at times may begin suddenly. These problems include: […] Blurred vision […] Double vision […] Sudden reduced vision (blindness in one or both eyes) […] Most people make a full recovery, but treatment may be needed for 1 to 2 years or longer. The condition may return at a later date. […] Damage to other blood vessels in the body, such as aneurysms (ballooning of the blood vessels), may occur. This damage can lead to a stroke in the future.

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

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

  The prognosis for patients with untreated GCA is extremely poor. These patients may suffer blindness, or death from myocardial infarction, stroke, or dissecting aortic aneurysm. […] Vision damage that occurs before initiation of therapy is often irreversible, especially in patients who have other ischemic complications. […] Progression of vision loss despite the initiation of high-dose corticosteroid therapy typically occurs within the first 5-6 days of treatment if therapy is going to fail. […] Risk factors for progressive visual loss despite steroid therapy include older age, elevated CRP level, and optic disc swelling. […] Nervous system alterations are found in as many as 30% of patients; 14% have either mononeuritis or polyneuropathy, and 7% have transient ischemic attacks or strokes. […] Rare but serious complications include myocardial infarction (MI) and visceral organ ischemia (eg, small-bowel infarction).

• #63 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  Vertebrobasilar events sometimes present as acute confusional states or coma as opposed to discrete focal syndromes. Presumably, cognitive changes reflect thalamic, mesial temporal, and mesencephalic involvement in most cases. Acute encephalopathy is a rare complication of GCA and is a poor prognostic sign. Many patients with this complication progress to coma and die.

• #64 Eyes – giant cell arteritis | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-giant-cell-arteritis

  Giant cell arteritis is inflammation of the arteries that can cause sudden blindness in one or both eyes. New onset headache and vision loss are the most common symptoms. If the blood vessels servicing the eyes are affected, sudden blindness in one or both eyes can result. This vision loss is usually severe and permanent. The symptoms of giant cell arteritis can include: Sudden and painless blindness in one eye. Sudden and painless blindness in the other eye this may occur one to 10 days later. […] Treatment includes immediate high-dose corticosteroids, which can provide symptom relief within 48 to 72 hours. Treatment aims to stop any more damage to the affected tissues. Quick action is needed to preserve the persons remaining sight.

• #65 Giant cell arteritis | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/giant-cell-arteritis?content_id=CON-20372739

  If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss. […] The main treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. Because immediate treatment is necessary to prevent vision loss, your doctor is likely to start medication even before confirming the diagnosis with a biopsy. […] You’ll likely begin to feel better within a few days of beginning treatment. If you have visual loss before starting treatment with corticosteroids, it’s unlikely that your vision will improve. However, your unaffected eye might be able to compensate for some of the visual changes. […] When giant cell arteritis is diagnosed and treated early, the prognosis is usually excellent. Your symptoms will likely improve quickly after beginning corticosteroid treatment, and your vision isn’t likely to be affected.

• #65 Giant Cell Arteritis : Johns Hopkins Vasculitis Center

  https://www.hopkinsvasculitis.org/types-vasculitis/giant-cell-arteritis/

  GCA commonly causes headaches, joint pain, facial pain, fever, and difficulties with vision, and sometimes permanent visual loss in one or both eyes. […] The most common symptoms of GCA are headache, pain in the shoulders and hips (called polymyalgia rheumatica), pain in the jaw after chewing (called jaw claudication), fever, and blurred vision. Other symptoms can include tenderness of scalp (it hurts to comb the hair), cough, throat pain, tongue pain, weight loss, depression, stroke, or pain in the arms during exercise. […] Blindness the most feared complication can develop if the disease is not treated in a timely fashion. […] GCA requires treatment with prednisone, a type of corticosteroid. Typically, treatment begins with 40-60 mg of prednisone, taken by mouth each day. Most patients improve rapidly and dramatically on this dose, with improvement of most symptoms in 1-3 days.

• #66 Giant Cell Arteritis | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/giantcellarteritis/

  GCA is primarily treated with high-dose steroids. The disease is typically active for 1-2 years, but in some cases, can last up to 10+ years. Therefore, people with GCA may take steroids for a long time. Headache and pain usually improve within 24-72 hours of starting treatment. Unfortunately, vision does not typically improve, and may even worsen despite treatment. The goal of prompt treatment is to prevent further visual loss and other serious complications of GCA like stroke and heart attack. […] Unfortunately, vision loss is typically permanent regardless of treatment. The goal of treatment is to avoid vision loss in the other eye, to limit worsening of vision, and to prevent damage to other organs.

• #67 Giant Cell Arteritis | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/giantcellarteritis/

  GCA is primarily treated with high-dose steroids. The disease is typically active for 1-2 years, but in some cases, can last up to 10+ years. Therefore, people with GCA may take steroids for a long time. Headache and pain usually improve within 24-72 hours of starting treatment. Unfortunately, vision does not typically improve, and may even worsen despite treatment. The goal of prompt treatment is to prevent further visual loss and other serious complications of GCA like stroke and heart attack. […] Unfortunately, vision loss is typically permanent regardless of treatment. The goal of treatment is to avoid vision loss in the other eye, to limit worsening of vision, and to prevent damage to other organs.

• #68 Giant cell arteritis | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/giant-cell-arteritis?content_id=CON-20372739

  If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss. […] The main treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. Because immediate treatment is necessary to prevent vision loss, your doctor is likely to start medication even before confirming the diagnosis with a biopsy. […] You’ll likely begin to feel better within a few days of beginning treatment. If you have visual loss before starting treatment with corticosteroids, it’s unlikely that your vision will improve. However, your unaffected eye might be able to compensate for some of the visual changes. […] When giant cell arteritis is diagnosed and treated early, the prognosis is usually excellent. Your symptoms will likely improve quickly after beginning corticosteroid treatment, and your vision isn’t likely to be affected.

• #69 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Symptoms of polymyalgia rheumatica (PMR) are present in up to 50% of patients. […] The visual prognosis is highly dependent on the rapidity with which steroids are started, and the status of the patients vision upon presentation. […] If the patient has already had an ischemic event resulting in AAION or a CRAO, it is rare that vision will improve appreciably. […] However, up to one-third of treated cases may demonstrate some small degree of improvement in acuity after treatment has been initiated. […] In general, vision often stabilizes once steroids are started; however, if it deteriorates on steroid therapy, it tends to be within 5 days and is rare after 1 month. […] It has been suggested that 9-17% of patients may have a deterioration of their vision while on corticosteroids. […] Additionally, one small study suggested that approximately 9% of patients can progress to fellow eye involvement after therapy is initiated; in contrast, 20-62% of untreated patients may progress to this stage.

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

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

  The prognosis for patients with untreated GCA is extremely poor. These patients may suffer blindness, or death from myocardial infarction, stroke, or dissecting aortic aneurysm. […] Vision damage that occurs before initiation of therapy is often irreversible, especially in patients who have other ischemic complications. […] Progression of vision loss despite the initiation of high-dose corticosteroid therapy typically occurs within the first 5-6 days of treatment if therapy is going to fail. […] Risk factors for progressive visual loss despite steroid therapy include older age, elevated CRP level, and optic disc swelling. […] Nervous system alterations are found in as many as 30% of patients; 14% have either mononeuritis or polyneuropathy, and 7% have transient ischemic attacks or strokes. […] Rare but serious complications include myocardial infarction (MI) and visceral organ ischemia (eg, small-bowel infarction).

• #71 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

• #72 Giant Cell Arteritis – Rheumatology Advisor

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

  Later research discovered that GCA is associated with a wide range of symptoms and signs, including tenderness in the temporal area, fever, malaise, headache, vision difficulties, and elevated levels of inflammatory markers. […] Acute headaches; scalp pain; jaw, tongue, or limb claudication; and vision impairments are the most frequent local symptoms. […] Common symptoms of GCA include severe headaches, tenderness in the scalp or temples, jaw pain, vision problems, fatigue, and weight loss. If GCA affects the blood supply of the eye, blurring of vision, double vision, or blindness can occur. However, this can be avoided with prompt diagnosis and treatment. […] The intensity of symptoms at the time of onset, as well as the speed with which steroids are started, contribute to the visual prognosis. The risk of vision loss is increased in cases of advanced age, thrombocytosis, and anemia.

• #73 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Suspect a relapse of GCA if the patients initial symptoms recur, if inflammatory markers become elevated, or if classic symptoms of GCA or polymyalgia rheumatica occur. […] The incidence of relapses of GCA in multiple tertiary care centers has been reported to vary between 34% and 75%. Most relapses occur at prednisone dosages of less than 20 mg orally daily and within the first year after diagnosis. The most common symptoms are limb ischemia, jaw claudication, constitutional symptoms, headaches, and polymyalgia rheumatica.

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

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

  Features associated with extra-cranial large vessel involvement include bruits (eg, carotid artery), decreased arterial pulsation/blood pressure difference between arms, intermittent arm/limb claudication (due to stenosis), and back or chest pain (due to aortitis or aortic dissection). […] Most people with giant cell arteritis respond rapidly to treatment with glucocorticoids. However, relapses are common and occur in up to 50% despite appropriate treatment.

• #75 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Suspect a relapse of GCA if the patients initial symptoms recur, if inflammatory markers become elevated, or if classic symptoms of GCA or polymyalgia rheumatica occur. […] The incidence of relapses of GCA in multiple tertiary care centers has been reported to vary between 34% and 75%. Most relapses occur at prednisone dosages of less than 20 mg orally daily and within the first year after diagnosis. The most common symptoms are limb ischemia, jaw claudication, constitutional symptoms, headaches, and polymyalgia rheumatica.

• #76 Giant Cell Arteritis – Vasculitis Foundation

  https://vasculitisfoundation.org/education/vasculitis-types/giant-cell-arteritis/

  Other common symptoms include: Flu-like symptoms at onset including fatigue, fever, and loss of appetite; Jaw pain when chewing; Sudden vision loss in one or both eyes; Visual blurriness in one or both eyes; Double vision; Arm pain, numbness, or weakness; Leg pain, numbness, or weakness; Aching and stiffness of shoulder and/or hip joints (worse in the morning); Dizziness; Weight loss. […] Left untreated, GCA can result in serious complications including blindness, stroke, or aortic aneurysm—an abnormal bulge in the wall of the aorta, which carries blood from the heart to the rest of the body. A burst aneurysm can be life-threatening. […] Even with effective treatment, relapse of GCA is common. Causes of relapse are not fully understood, although infections can be a trigger. If your initial symptoms return or you develop new ones, report them to your doctor as soon as possible. Regular doctor visits and ongoing monitoring of laboratory and imaging tests are important in detecting relapses early.

• #77 Giant Cell Arteritis (Temporal Arteritis)

  https://www.medicinenet.com/giant_cell_arteritis_gca_or_temporal_arteritis/article.htm

  With prompt treatment, the prognosis for GCA is reasonable, with most patients having their symptoms controlled and resolved in one to two years. Some patients develop a chronic condition that needs care stretching over many years. […] There can be early relapses within the first year. Usually, a relapse occurs when the prednisone dosage has been tapered too low to prevent artery inflammation. Headache is the most common symptom. […] Most often, giant cell arteritis resolves within one to two years. Some patients may have a chronic disease state where treatment is required for much longer.

• #78 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Suspect a relapse of GCA if the patients initial symptoms recur, if inflammatory markers become elevated, or if classic symptoms of GCA or polymyalgia rheumatica occur. […] The incidence of relapses of GCA in multiple tertiary care centers has been reported to vary between 34% and 75%. Most relapses occur at prednisone dosages of less than 20 mg orally daily and within the first year after diagnosis. The most common symptoms are limb ischemia, jaw claudication, constitutional symptoms, headaches, and polymyalgia rheumatica.

• #79 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Suspect a relapse of GCA if the patients initial symptoms recur, if inflammatory markers become elevated, or if classic symptoms of GCA or polymyalgia rheumatica occur. […] The incidence of relapses of GCA in multiple tertiary care centers has been reported to vary between 34% and 75%. Most relapses occur at prednisone dosages of less than 20 mg orally daily and within the first year after diagnosis. The most common symptoms are limb ischemia, jaw claudication, constitutional symptoms, headaches, and polymyalgia rheumatica.

• #80 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Suspect a relapse of GCA if the patients initial symptoms recur, if inflammatory markers become elevated, or if classic symptoms of GCA or polymyalgia rheumatica occur. […] The incidence of relapses of GCA in multiple tertiary care centers has been reported to vary between 34% and 75%. Most relapses occur at prednisone dosages of less than 20 mg orally daily and within the first year after diagnosis. The most common symptoms are limb ischemia, jaw claudication, constitutional symptoms, headaches, and polymyalgia rheumatica.

• #81 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Suspect a relapse of GCA if the patients initial symptoms recur, if inflammatory markers become elevated, or if classic symptoms of GCA or polymyalgia rheumatica occur. […] The incidence of relapses of GCA in multiple tertiary care centers has been reported to vary between 34% and 75%. Most relapses occur at prednisone dosages of less than 20 mg orally daily and within the first year after diagnosis. The most common symptoms are limb ischemia, jaw claudication, constitutional symptoms, headaches, and polymyalgia rheumatica.

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

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

  Other scenarios that warrant suspicion in such patients are jaw claudication, unexplained fever or other constitutional symptoms, abrupt visual disturbance or loss, and signs of vascular abnormalities. […] Jaw claudication, occurring in nearly 50% of patients with GCA, manifests as pain or fatigue in the mandible and occasionally the tongue, triggered by chewing, and typically subsides upon cessation of chewing. […] Approximately 20% to 30% of the patients experience visual disturbances. GCA-associated visual loss can be transient or permanent. […] Transient visual changes typically present as an abrupt partial field defect or as if a curtain covers the field of vision of 1 eye. Permanent vision loss, most often resulting from anterior ischemic optic neuropathy, is painless and sudden, and it can be unilateral, bilateral, partial, or complete. […] Symptoms consistent with polymyalgia rheumatica are the most frequent presentation associated with a relapse of GCA.

• #83 Giant cell arteritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/diagnosis-treatment/drc-20372764

  Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of other common conditions. […] Often, one or both of these arteries are tender, with a reduced pulse and a hard, cordlike feel and appearance. […] If you have giant cell arteritis, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name. […] The main treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. […] You’ll likely begin to feel better within a few days of beginning treatment. […] Some symptoms, particularly headaches, may return during this tapering period. […] When giant cell arteritis is diagnosed and treated early, the prognosis is usually excellent. […] Your symptoms will likely improve quickly after beginning corticosteroid treatment, and your vision isn’t likely to be affected.

• #84 Giant cell arteritis // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/giant-cell-arteritis

  You’ll likely begin to feel better within a few days of beginning treatment. If you have visual loss before starting treatment with corticosteroids, it’s unlikely that your vision will improve. However, your unaffected eye might be able to compensate for some of the visual changes. […] Some symptoms, particularly headaches, may return during this tapering period. This is the point at which many people also develop symptoms of polymyalgia rheumatica. Such flares can usually be treated with slight increases in the corticosteroid dose.

• #85 Giant Cell Arteritis | CommonSpirit Health

  https://www.commonspirit.org/conditions-treatments/giant-cell-arteritis

  Symptoms may start either suddenly or slowly. They may include: […] A new headache, often near the temple or around the eye. This is the most common symptom. […] Pain in the jaw, especially when you chew. […] Vision problems such as double vision or brief loss of vision. […] Tenderness on the side of the head or scalp. The blood vessel on the temple may look swollen. And it may hurt to wear glasses or comb your hair. […] In some people, symptoms improve with treatment but then come back. This is called a relapse. It often occurs in the first 2 years of treatment or during the first year after steroid medicine is stopped. Your doctor will track your condition during this time. If you have a relapse, your doctor will increase the steroid dosage for a while. Then you can slowly lower it after your symptoms go away.

• #86 Giant cell arteritis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/diagnosis-treatment/drc-20372764

  Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of other common conditions. […] Often, one or both of these arteries are tender, with a reduced pulse and a hard, cordlike feel and appearance. […] If you have giant cell arteritis, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name. […] The main treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. […] You’ll likely begin to feel better within a few days of beginning treatment. […] Some symptoms, particularly headaches, may return during this tapering period. […] When giant cell arteritis is diagnosed and treated early, the prognosis is usually excellent. […] Your symptoms will likely improve quickly after beginning corticosteroid treatment, and your vision isn’t likely to be affected.

• #87 Giant Cell Arteritis / Temporal Arteritis – Vasculitis UK

  https://www.vasculitis.org.uk/about-vasculitis/giant-cell-arteritis-temporal-arteritis

  Symptoms of fatigue, loss of appetite, weight loss and fever are often found. Headache, with pain and tenderness over the temples, is a prominent feature of this disease due to inflammation of the temporal arteries. […] A classic symptom of this condition is pain in the tongue or jaw when eating (jaw claudication). Reduction of the blood supply to the brain can cause a stroke. Reduction in the blood supply to the eyes can lead to blurred vision, or in some patients, blindness. […] The prognosis is good with correct and early diagnosis and treatment.

• #88 Giant Cell Arteritis Causes, Symptoms, and Treatments

  https://www.upmc.com/services/heart-vascular/conditions/giant-cell-arteritis

  Giant cell arteritis symptoms can include: […] Headache, especially around the temples. […] Pain in the shoulders and hips (polymyalgia rheumatica). […] Jaw pain after chewing. […] Fever. […] Blurred vision or vision loss. […] In some cases, symptoms may also include: […] Scalp tenderness. […] Jaw or facial pain. […] Cough. […] Pain in the throat or tongue. […] Weight loss. […] Depression. […] Pain in the arms during exercise. […] If left untreated, giant cell arteritis can lead to serious and even life-threatening complications like permanent blindness and stroke. […] Most people improve quickly once they begin treatment. […] You will need to remain on steroids for at least 1 to 2 years following a giant cell arteritis diagnosis. In some cases, you may need longer-term treatment. […] Also, giant cell arteritis can recur even after treatment.

• #89 Giant Cell Arteritis (Temporal Arteritis) – Harvard Health

  https://www.health.harvard.edu/a_to_z/giant-cell-arteritis-temporal-arteritis-a-to-z

  Giant cell arteritis typically lasts at least several years. However, improvement usually begins within days of starting therapy. Some people are able to discontinue treatment within six months, but longer treatment over two to three years is more usual. Occasionally, the disease returns after it has gone away for a prolonged period. […] If vision has not been affected, the outlook is excellent. However, once vision loss occurs, it is usually permanent. If the aorta or nearby branches are involved, the prognosis may be worse, because these blood vessels may enlarge or even rupture. However, most complications related to giant cell arteritis are caused by steroid therapy rather the disease itself.

• #90 Giant Cell Arteritis (Temporal Arteritis)

  https://www.medicinenet.com/giant_cell_arteritis_gca_or_temporal_arteritis/article.htm

  With prompt treatment, the prognosis for GCA is reasonable, with most patients having their symptoms controlled and resolved in one to two years. Some patients develop a chronic condition that needs care stretching over many years. […] There can be early relapses within the first year. Usually, a relapse occurs when the prednisone dosage has been tapered too low to prevent artery inflammation. Headache is the most common symptom. […] Most often, giant cell arteritis resolves within one to two years. Some patients may have a chronic disease state where treatment is required for much longer.

• #91 Giant Cell Arteritis – Symptoms, Causes and Treatments

  https://resources.healthgrades.com/right-care/vascular-conditions/giant-cell-arteritis

  About half of people with GCA also develop polymyalgia rheumatica with joint pain and stiffness. Sudden and permanent vision loss can occur. Seek prompt medical care for any symptoms of GCA or new, persistent headache. Starting treatment right away can prevent blindness. […] Having GCA increases the risk of serious complications, such as stroke and aneurysm, which can be fatal. However, research suggests that people with GCA have the same life expectancy as people without the disease. […] GCA treatment consists of high dose corticosteroids, such as prednisone. These powerful anti-inflammatory drugs can quickly treat the condition and prevent permanent blindness. In fact, your doctor may start this treatment while confirming the diagnosis. However, corticosteroids cannot reverse any vision loss you already have. […] Once your symptoms are stable, your doctor may try to taper down your corticosteroid dose. The goal is to reach the lowest dose that will manage the disease symptoms. In most cases, treatment will continue for a couple of years or longer.

• #92 Giant Cell Arteritis – Vasculitis Foundation

  https://vasculitisfoundation.org/education/vasculitis-types/giant-cell-arteritis/

  There is no cure at this time for GCA, but with early treatment and careful monitoring, most patients with GCA have a good prognosis. Symptoms generally improve within days of starting treatment, and with proper medical care the disease can run its course in one to two years. Left untreated, however, GCA can lead to serious complications including blindness, stroke, and aneurysms. Newer medications such as the biologic drug, tocilizumab, offer hope for treating this disease with less exposure to corticosteroids.

• #93 Giant Cell Arteritis – Vasculitis Foundation

  https://vasculitisfoundation.org/education/vasculitis-types/giant-cell-arteritis/

  There is no cure at this time for GCA, but with early treatment and careful monitoring, most patients with GCA have a good prognosis. Symptoms generally improve within days of starting treatment, and with proper medical care the disease can run its course in one to two years. Left untreated, however, GCA can lead to serious complications including blindness, stroke, and aneurysms. Newer medications such as the biologic drug, tocilizumab, offer hope for treating this disease with less exposure to corticosteroids.

• #94 Giant Cell Arteritis

  https://www.cham.org/HealthwiseArticle.aspx?id=abp6943

  Symptoms may start either suddenly or slowly. They may include: […] A new headache, often near the temple or around the eye. This is the most common symptom. […] Pain in the jaw, especially when you chew. […] Vision problems such as double vision or brief loss of vision. […] Tenderness on the side of the head or scalp. The blood vessel on the temple may look swollen. And it may hurt to wear glasses or comb your hair. […] Most of the time, symptoms improve quickly and go away 2 to 4 weeks after treatment starts. […] In some people, symptoms improve with treatment but then come back. This is called a relapse. It often occurs in the first 2 years of treatment or during the first year after steroid medicine is stopped. […] Your doctor may prescribe another medicine, such as methotrexate or tocilizumab, if you continue to have symptoms after your steroid dose is lowered. This is sometimes called steroid-sparing treatment.

• #95 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Giant cell arteritis can present with cranial symptoms, extracranial large-vessel involvement, or polymyalgia rheumatica. […] The initial symptoms of GCA may be vague, such as malaise, fever, and night sweats, and are likely due to systemic inflammation. Features of vascular involvement include headache, scalp tenderness, and jaw claudication (cramping pain in the jaw while chewing). […] A less common but serious feature associated with GCA is partial or complete vision loss affecting 1 or both eyes. Some patients suddenly go completely blind without any visual prodrome. […] Overlapping GCA phenotypes exist, with a spectrum of presentations that include classic cranial arteritis, extracranial GCA (also called large-vessel GCA), and polymyalgia rheumatica. […] Cranial GCA, the best-characterized clinical presentation, causes symptoms such as headache or signs such as tenderness of the temporal artery.

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

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

  GCA has heterogeneous clinical features due to the overlapping spectrum of the known clinical phenotypes: cranial GCA (C-GCA), large vessel GCA (LV-GCA), and polymyalgia rheumatica (PMR) (Fig. 2). The majority of people with cranial GCA will have symptoms of new onset headache, jaw claudication and cutaneous allodynia. Nearly half of people with GCA have symptoms of PMR while up to one-fifth of people with PMR will be diagnosed with GCA. There may be large vessel involvement in cranial GCA, which may be asymptomatic and revealed by diagnostic imaging alone. Up to 50% of people with GCA will experience constitutional symptoms such as fever, weight loss, night sweats, loss of appetite, malaise, depression. These may help narrow the differential diagnosis from an ocular cause or pain syndrome (such as migraine or cluster headache) to a systemic cause, however many systemic conditions have the potential to exhibit these symptoms.

• #97 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Giant cell arteritis can present with cranial symptoms, extracranial large-vessel involvement, or polymyalgia rheumatica. […] The initial symptoms of GCA may be vague, such as malaise, fever, and night sweats, and are likely due to systemic inflammation. Features of vascular involvement include headache, scalp tenderness, and jaw claudication (cramping pain in the jaw while chewing). […] A less common but serious feature associated with GCA is partial or complete vision loss affecting 1 or both eyes. Some patients suddenly go completely blind without any visual prodrome. […] Overlapping GCA phenotypes exist, with a spectrum of presentations that include classic cranial arteritis, extracranial GCA (also called large-vessel GCA), and polymyalgia rheumatica. […] Cranial GCA, the best-characterized clinical presentation, causes symptoms such as headache or signs such as tenderness of the temporal artery.

• #98 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Giant cell arteritis can present with cranial symptoms, extracranial large-vessel involvement, or polymyalgia rheumatica. […] The initial symptoms of GCA may be vague, such as malaise, fever, and night sweats, and are likely due to systemic inflammation. Features of vascular involvement include headache, scalp tenderness, and jaw claudication (cramping pain in the jaw while chewing). […] A less common but serious feature associated with GCA is partial or complete vision loss affecting 1 or both eyes. Some patients suddenly go completely blind without any visual prodrome. […] Overlapping GCA phenotypes exist, with a spectrum of presentations that include classic cranial arteritis, extracranial GCA (also called large-vessel GCA), and polymyalgia rheumatica. […] Cranial GCA, the best-characterized clinical presentation, causes symptoms such as headache or signs such as tenderness of the temporal artery.

• #99 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #100 Giant cell arteritis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/giant-cell-arteritis/symptoms-causes/syc-20372758

  Giant cell arteritis frequently causes headaches, scalp tenderness, jaw pain and vision problems. Untreated, it can lead to blindness. […] The most common symptoms of giant cell arteritis are head pain and tenderness often severe that usually affects both temples. Head pain can progressively worsen, come and go, or subside temporarily. […] Generally, signs and symptoms of giant cell arteritis include: Persistent, severe head pain, usually in your temple area; Scalp tenderness; Jaw pain when you chew or open your mouth wide; Fever; Fatigue; Unintended weight loss; Vision loss or double vision, particularly in people who also have jaw pain; Sudden, permanent loss of vision in one eye. […] If you develop a new, persistent headache or any of the signs and symptoms listed above, see your doctor without delay. If you’re diagnosed with giant cell arteritis, starting treatment as soon as possible can usually help prevent vision loss.

• #101 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #102 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #103 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #104 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #105 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #106 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #107 Clinical manifestations of giant cell arteritis – UpToDate

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

  Clinical manifestations of giant cell arteritis […] The onset of symptoms in giant cell arteritis (GCA) tends to be subacute, but abrupt presentations over a few days can occur. […] Systemic symptoms associated with GCA are frequent and include fever, fatigue, and weight loss. […] Headache is a common presentation of GCA, occurring in more than two-thirds of patients. […] Nearly one-half of GCA patients experience jaw claudication, a symptom that involves mandibular pain or fatigue brought on by mastication and relieved by stopping. […] Transient monocular (and, rarely, binocular) impairment of vision can be an early manifestation of GCA. […] Unquestionably the most feared complication of GCA remains that of permanent loss of vision, which commonly is painless and sudden, may be partial or complete, and may be unilateral or bilateral. […] The clinical consequences of LV GCA comprise aneurysms and dissections of the aorta, particularly the thoracic aorta, as well as stenosis, occlusion, and ectasia of large arteries. […] GCA can affect the subclavian arteries distal to the take-off of the vertebral arteries and extend through the axillary arteries to the proximal brachial arteries. […] Stroke is uncommon in GCA. […] GCA is an unusual cause of ischemic stroke. […] Patients with GCA can present upper respiratory tract symptoms, in particular a nonproductive cough. […] A variety of unusual presentations of GCA have been reported.

• #108 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

• #109 Temporal arteritis (Giant Cell Arteritis)

  https://neurologynetwork.com.au/neuro-ophthalmology/giant-cell-arteritis/

  These may develop gradually and can be present for weeks: tiredness, depression, night sweats, fever, loss of appetite, weight loss. […] Up to half of people with temporal arteritis/GCA develop a related condition called polymyalgia rheumatica (PMR). If this develops it often occurs at the same time, but may occur before or after the development of GCA. The typical symptoms of PMR are pain, tenderness and stiffness of muscles around the shoulders and upper arms, and sometimes around the hips and neck. PMR is due to inflammation in the affected muscles, but the cause is unknown. The treatment is similar for both conditions. Treatment for PMR is usually very effective.

• #110 Giant cell arteritis: An updated review of an old disease | Cleveland Clinic Journal of Medicine

  https://www.ccjm.org/content/86/7/465

  Visual disturbance, jaw claudication, and tongue pain are less common but, if present, increase the likelihood of this diagnosis. […] Large-vessel involvement in GCA is common and refers to involvement of the aorta and its proximal branches. […] Depending on the imaging study, large-vessel involvement has been found in 30% to 80% of cases of GCA. It is often associated with nonspecific symptoms such as fever, weight loss, chills, and malaise, but it can also cause more specific symptoms such as unilateral extremity claudication. […] The finding of aortitis should prompt the clinician to question the patient about other symptoms of GCA and to order imaging of the whole vascular tree. […] Polymyalgia rheumatica is observed in 40% to 60% of patients with GCA at the time of diagnosis; 16% to 21% of patients with polymyalgia rheumatica may develop GCA, especially if untreated.

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

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

  Other scenarios that warrant suspicion in such patients are jaw claudication, unexplained fever or other constitutional symptoms, abrupt visual disturbance or loss, and signs of vascular abnormalities. […] Jaw claudication, occurring in nearly 50% of patients with GCA, manifests as pain or fatigue in the mandible and occasionally the tongue, triggered by chewing, and typically subsides upon cessation of chewing. […] Approximately 20% to 30% of the patients experience visual disturbances. GCA-associated visual loss can be transient or permanent. […] Transient visual changes typically present as an abrupt partial field defect or as if a curtain covers the field of vision of 1 eye. Permanent vision loss, most often resulting from anterior ischemic optic neuropathy, is painless and sudden, and it can be unilateral, bilateral, partial, or complete. […] Symptoms consistent with polymyalgia rheumatica are the most frequent presentation associated with a relapse of GCA.

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

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

  The visual symptoms of GCA are well documented and include amaurosis fugax, double vision to devastating visual loss. The most common ocular manifestations include anterior ischaemic optic neuropathy, large peripapillary cotton wool spots, arterial occlusions (cilio-retinal artery or central artery), oculomotor cranial nerve palsy, and posterior ischaemic optic neuropathy, with other rarer ocular syndromes having been reported. Initiation of treatment may result in reversal of visual loss in the minority. […] GCA can present without any symptoms of cranial or large vessel involvement, with inflammation or fever of unknown origin (IFUO), anorexia, weight loss and anaemia being the only evidence of an active disease process. Patients with constitutional GCA are at risk of significant diagnostic delay due to the large differential diagnosis of IFUO.

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

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

  The visual symptoms of GCA are well documented and include amaurosis fugax, double vision to devastating visual loss. The most common ocular manifestations include anterior ischaemic optic neuropathy, large peripapillary cotton wool spots, arterial occlusions (cilio-retinal artery or central artery), oculomotor cranial nerve palsy, and posterior ischaemic optic neuropathy, with other rarer ocular syndromes having been reported. Initiation of treatment may result in reversal of visual loss in the minority. […] GCA can present without any symptoms of cranial or large vessel involvement, with inflammation or fever of unknown origin (IFUO), anorexia, weight loss and anaemia being the only evidence of an active disease process. Patients with constitutional GCA are at risk of significant diagnostic delay due to the large differential diagnosis of IFUO.

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

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

  The prognosis for patients with untreated GCA is extremely poor. These patients may suffer blindness, or death from myocardial infarction, stroke, or dissecting aortic aneurysm. […] Vision damage that occurs before initiation of therapy is often irreversible, especially in patients who have other ischemic complications. […] Progression of vision loss despite the initiation of high-dose corticosteroid therapy typically occurs within the first 5-6 days of treatment if therapy is going to fail. […] Risk factors for progressive visual loss despite steroid therapy include older age, elevated CRP level, and optic disc swelling. […] Nervous system alterations are found in as many as 30% of patients; 14% have either mononeuritis or polyneuropathy, and 7% have transient ischemic attacks or strokes. […] Rare but serious complications include myocardial infarction (MI) and visceral organ ischemia (eg, small-bowel infarction).

• #115 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

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

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

  The prognosis for patients with untreated GCA is extremely poor. These patients may suffer blindness, or death from myocardial infarction, stroke, or dissecting aortic aneurysm. […] Vision damage that occurs before initiation of therapy is often irreversible, especially in patients who have other ischemic complications. […] Progression of vision loss despite the initiation of high-dose corticosteroid therapy typically occurs within the first 5-6 days of treatment if therapy is going to fail. […] Risk factors for progressive visual loss despite steroid therapy include older age, elevated CRP level, and optic disc swelling. […] Nervous system alterations are found in as many as 30% of patients; 14% have either mononeuritis or polyneuropathy, and 7% have transient ischemic attacks or strokes. […] Rare but serious complications include myocardial infarction (MI) and visceral organ ischemia (eg, small-bowel infarction).

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

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

  The prognosis for patients with untreated GCA is extremely poor. These patients may suffer blindness, or death from myocardial infarction, stroke, or dissecting aortic aneurysm. […] Vision damage that occurs before initiation of therapy is often irreversible, especially in patients who have other ischemic complications. […] Progression of vision loss despite the initiation of high-dose corticosteroid therapy typically occurs within the first 5-6 days of treatment if therapy is going to fail. […] Risk factors for progressive visual loss despite steroid therapy include older age, elevated CRP level, and optic disc swelling. […] Nervous system alterations are found in as many as 30% of patients; 14% have either mononeuritis or polyneuropathy, and 7% have transient ischemic attacks or strokes. […] Rare but serious complications include myocardial infarction (MI) and visceral organ ischemia (eg, small-bowel infarction).

• #118 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

• #119 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

• #120 Giant Cell Arteritis (Temporal Arteritis) Clinical Presentation: History, Physical Examination

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

  Jaw claudication is noted as fatigue or discomfort of the jaw muscles during chewing of firm foods such as meat, chewing gum, or prolonged speaking. Jaw claudication is highly predictive of temporal arteritis, and it is a result of ischemia of the maxillary artery supplying the masseter muscles. […] Around 50% of patients with GCA experience visual symptoms over the course of the disease. Initial visual symptoms may be transient and intermittent, typically consisting of unilateral visual blurring or vision loss, often painless, or occasionally diplopia. Alternatively, a partial field defect may progress to complete blindness over days. […] Transient repeated episodes of blurred vision are usually reversible, but sudden irreversible loss of vision may occur, especially if treatment is not started promptly. If GCA remains untreated in patients with unilateral vision loss, the second eye may become affected within 1-2 weeks.

• #121 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

• #122 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

• #123 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Symptoms of polymyalgia rheumatica (PMR) are present in up to 50% of patients. […] The visual prognosis is highly dependent on the rapidity with which steroids are started, and the status of the patients vision upon presentation. […] If the patient has already had an ischemic event resulting in AAION or a CRAO, it is rare that vision will improve appreciably. […] However, up to one-third of treated cases may demonstrate some small degree of improvement in acuity after treatment has been initiated. […] In general, vision often stabilizes once steroids are started; however, if it deteriorates on steroid therapy, it tends to be within 5 days and is rare after 1 month. […] It has been suggested that 9-17% of patients may have a deterioration of their vision while on corticosteroids. […] Additionally, one small study suggested that approximately 9% of patients can progress to fellow eye involvement after therapy is initiated; in contrast, 20-62% of untreated patients may progress to this stage.

• #124 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Symptoms of polymyalgia rheumatica (PMR) are present in up to 50% of patients. […] The visual prognosis is highly dependent on the rapidity with which steroids are started, and the status of the patients vision upon presentation. […] If the patient has already had an ischemic event resulting in AAION or a CRAO, it is rare that vision will improve appreciably. […] However, up to one-third of treated cases may demonstrate some small degree of improvement in acuity after treatment has been initiated. […] In general, vision often stabilizes once steroids are started; however, if it deteriorates on steroid therapy, it tends to be within 5 days and is rare after 1 month. […] It has been suggested that 9-17% of patients may have a deterioration of their vision while on corticosteroids. […] Additionally, one small study suggested that approximately 9% of patients can progress to fellow eye involvement after therapy is initiated; in contrast, 20-62% of untreated patients may progress to this stage.

• #125 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Symptoms of polymyalgia rheumatica (PMR) are present in up to 50% of patients. […] The visual prognosis is highly dependent on the rapidity with which steroids are started, and the status of the patients vision upon presentation. […] If the patient has already had an ischemic event resulting in AAION or a CRAO, it is rare that vision will improve appreciably. […] However, up to one-third of treated cases may demonstrate some small degree of improvement in acuity after treatment has been initiated. […] In general, vision often stabilizes once steroids are started; however, if it deteriorates on steroid therapy, it tends to be within 5 days and is rare after 1 month. […] It has been suggested that 9-17% of patients may have a deterioration of their vision while on corticosteroids. […] Additionally, one small study suggested that approximately 9% of patients can progress to fellow eye involvement after therapy is initiated; in contrast, 20-62% of untreated patients may progress to this stage.

• #126 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Symptoms of polymyalgia rheumatica (PMR) are present in up to 50% of patients. […] The visual prognosis is highly dependent on the rapidity with which steroids are started, and the status of the patients vision upon presentation. […] If the patient has already had an ischemic event resulting in AAION or a CRAO, it is rare that vision will improve appreciably. […] However, up to one-third of treated cases may demonstrate some small degree of improvement in acuity after treatment has been initiated. […] In general, vision often stabilizes once steroids are started; however, if it deteriorates on steroid therapy, it tends to be within 5 days and is rare after 1 month. […] It has been suggested that 9-17% of patients may have a deterioration of their vision while on corticosteroids. […] Additionally, one small study suggested that approximately 9% of patients can progress to fellow eye involvement after therapy is initiated; in contrast, 20-62% of untreated patients may progress to this stage.

• #127 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  If there is visual deterioration after treatment is initiated, the prognosis is grim, with 80% of patients progressing to light perception or no light perception in one small study. […] Features that are associated with a worse visual prognosis include visual symptoms before the steroids are initiated, older age, fever, weight loss, antecedent transient visual loss, diplopia, and jaw claudication.

• #128 Giant Cell Arteritis – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/medicine/rheumatology-inflammation-immunity/arthritis-and-joint-diseases-center/giant-cell-arteritis

  Symptoms of giant cell arteritis may include: […] If GCA involves the blood supply to the eye, vision can be affected. Visual symptoms include temporary blurring of eyesight in one eye, double vision, and actual blindness. Loss of vision in GCA can occur suddenly, and usually cannot be reversed. […] If there is no loss of vision when the diagnosis of GCA is made, and if treatment is promptly started with daily, high-dose Prednisone, the risk of subsequent visual loss is essentially abolished.

• #129 Patient education: Polymyalgia rheumatica and giant cell arteritis (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/polymyalgia-rheumatica-and-giant-cell-arteritis-beyond-the-basics/print

  Giant cell arteritis progression — Giant cell arteritis (GCA) also tends to run its course, though occasionally headache and other symptoms can reappear during the first few months after it has been diagnosed. But it is important to remember that if vision is intact when GCA is diagnosed, and if higher-dose, daily glucocorticoid treatment is started immediately, the risk of future vision loss is very small. The dose of glucocorticoids can eventually be reduced and then eventually stopped in most patients.

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

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

  The prognosis for patients with untreated GCA is extremely poor. These patients may suffer blindness, or death from myocardial infarction, stroke, or dissecting aortic aneurysm. […] Vision damage that occurs before initiation of therapy is often irreversible, especially in patients who have other ischemic complications. […] Progression of vision loss despite the initiation of high-dose corticosteroid therapy typically occurs within the first 5-6 days of treatment if therapy is going to fail. […] Risk factors for progressive visual loss despite steroid therapy include older age, elevated CRP level, and optic disc swelling. […] Nervous system alterations are found in as many as 30% of patients; 14% have either mononeuritis or polyneuropathy, and 7% have transient ischemic attacks or strokes. […] Rare but serious complications include myocardial infarction (MI) and visceral organ ischemia (eg, small-bowel infarction).

• #131 Giant Cell Arteritis – EyeWiki

  https://eyewiki.org/Giant_Cell_Arteritis

  Giant cell arteritis (GCA) is the most common primary vasculitis in adults. […] In addition to vision loss, patients commonly note associated symptoms such as headache, jaw claudication, diplopia, myalgias, and constitutional symptoms. […] The most commonly feared sequela of GCA is permanent visual loss secondary to arteritic anterior ischemic optic neuropathy (AAION). […] When GCA is suspected, treatment with corticosteroids is indicated on an urgent basis, as further vision loss and fellow eye involvement are usually preventable. […] The most common ocular manifestation in GCA is acute unilateral vision loss, which has been reported in 7-60% of patients with GCA. […] Typically, the vision loss is secondary to optic nerve ischemia (AAION); it is less commonly due to a central retinal artery occlusion.

• #132

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

  Giant cell arteritis usually affects people aged over 50 years, and is only rarely seen in younger people. […] Symptoms of giant cell arteritis include headache, scalp tenderness, jaw claudication or other orofacial pain, neck or shoulder pain, visual disturbances and systemic symptoms, such as sweats, fever and anorexia. […] Visual loss, due to ischaemic optic neuropathy, is an early manifestation and can be a presenting symptom. This occurs in 20-50% of people with giant cell arteritis if they are untreated. […] Giant cell arteritis should be strongly considered in older patients presenting with a new type of headache, jaw pain or visual disturbances. […] Abrupt onset of headache is the most frequent symptom of giant cell arteritis, and will be present in approximately 75% of cases.

• #133 Giant Cell Arteritis | North American Neuro-Ophthalmology Society

  https://www.nanosweb.org/giantcellarteritis/

  Giant cell arteritis is an inflammatory condition that can cause vision loss, double vision, fever, new persistent headaches, scalp tenderness, and jaw pain with chewing. […] Vision loss in one or both eyes occurs in 20-50% of patients. Approximately 1/3 of patients who lose vision from GCA experience transient vision loss in one eye 7-10 days prior to the permanent vision loss. If not recognized and treated promptly, the second eye will lose vision within 7-10 days in 70% of cases. Vision loss is typically severe and almost always irreversible, even with treatment. For this reason, early diagnosis and prompt treatment are imperative. Intermittent or sustained double vision can also be a warning sign of impending visual loss. […] The most common initial GCA symptom is a new persistent headache, which is present in 40-90% of patients. Scalp tenderness is also common and often noticed when brushing or washing hair, or sleeping on one side of the head. Less common, but important symptoms include pain and fatigue in the jaw, ear, tongue, throat, or neck while chewing or swallowing, especially after doing so for a few minutes. These symptoms, called jaw claudication, are very concerning for GCA and should be taken very seriously.

• #134 Giant Cell Arteritis – Vasculitis Foundation

  https://vasculitisfoundation.org/education/vasculitis-types/giant-cell-arteritis/

  Other common symptoms include: Flu-like symptoms at onset including fatigue, fever, and loss of appetite; Jaw pain when chewing; Sudden vision loss in one or both eyes; Visual blurriness in one or both eyes; Double vision; Arm pain, numbness, or weakness; Leg pain, numbness, or weakness; Aching and stiffness of shoulder and/or hip joints (worse in the morning); Dizziness; Weight loss. […] Left untreated, GCA can result in serious complications including blindness, stroke, or aortic aneurysm—an abnormal bulge in the wall of the aorta, which carries blood from the heart to the rest of the body. A burst aneurysm can be life-threatening. […] Even with effective treatment, relapse of GCA is common. Causes of relapse are not fully understood, although infections can be a trigger. If your initial symptoms return or you develop new ones, report them to your doctor as soon as possible. Regular doctor visits and ongoing monitoring of laboratory and imaging tests are important in detecting relapses early.

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

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

  Giant cell arteritis, prevalent among older individuals, affects medium to large arteries, exhibiting diverse clinical manifestations in both cranial and extracranial locations. Patients with the classic cranial phenotype present with nonspecific constitutional symptoms, headaches, jaw claudication, and an abnormal temporal artery biopsy, whereas isolated radiographic evidence of arteritis may characterize an alternative presentation. […] Clinicians should consider giant cell arteritis in individuals over 50 with new or altered headaches, jaw claudication, fever, visual disturbances, or vascular abnormalities. […] Tongue pain, although rare, significantly raises the likelihood of giant cell arteritis. […] Vascular irregularities may manifest as limb claudication, asymmetric blood pressures, an abnormal radial pulse, and temporal artery abnormalities.

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

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

  Other scenarios that warrant suspicion in such patients are jaw claudication, unexplained fever or other constitutional symptoms, abrupt visual disturbance or loss, and signs of vascular abnormalities. […] Jaw claudication, occurring in nearly 50% of patients with GCA, manifests as pain or fatigue in the mandible and occasionally the tongue, triggered by chewing, and typically subsides upon cessation of chewing. […] Approximately 20% to 30% of the patients experience visual disturbances. GCA-associated visual loss can be transient or permanent. […] Transient visual changes typically present as an abrupt partial field defect or as if a curtain covers the field of vision of 1 eye. Permanent vision loss, most often resulting from anterior ischemic optic neuropathy, is painless and sudden, and it can be unilateral, bilateral, partial, or complete. […] Symptoms consistent with polymyalgia rheumatica are the most frequent presentation associated with a relapse of GCA.

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