Giant Cell Arteritis

Giant Cell Arteritis (GCA) is the most common systemic vasculitis. It targets large and medium caliber vessels and its classic symptoms result from a predilection for the cranial branches of the carotid arteries. It is a disorder of middle to older age and rarely affects individuals younger than 50. Diagnostic dilemmas frequently result from clinical presentations that can be highly variable and diagnostic tests that are often nonspecific or unreliable. The consequences of missing the diagnosis are high, with permanent vision loss occurring in 15–20% of patients. However, because it is a disease of older patients, often with medical comorbidities, standard treatment with systemic corticosteroids is far from benign in many cases. Accurate diagnosis and effective treatment require a high index of suspicion in nonspecific presentations, careful examination and diagnostic workup and, at times, tolerance for uncertainty in choosing the best clinical approach for each patient in which GCA is suspected.