From the Guidelines
Temporal arteritis, also known as giant cell arteritis, typically presents with symptoms such as a new, severe headache, scalp tenderness, jaw claudication, visual disturbances, and systemic symptoms like fever, fatigue, and unintentional weight loss, as reported in the 2021 American College of Rheumatology/Vasculitis Foundation guideline for the management of giant cell arteritis and Takayasu arteritis 1. The clinical presentation of GCA is varied, requiring a heightened suspicion by clinicians for early diagnosis. Half of the patients report constitutional symptoms, such as weight loss, night sweats, malaise, and fever, as noted in the 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease 1. Some key symptoms include:
- Scalp tenderness and headache, present in two thirds of patients and in up to 90% of patients with biopsy-proved disease 1
- Jaw claudication, common and affects half of the patients 1
- Visual disturbances, such as diplopia, amaurosis fugax, or blurriness prior to blindness, reported by 20% of patients 1
- Systemic symptoms, including fever, fatigue, unintentional weight loss, and general malaise 1 It is essential to note that these symptoms can occur in adults over 50, and immediate medical evaluation is crucial to prevent vision loss and other complications. The diagnosis of GCA can be established through temporal artery biopsy, which is conditionally recommended over magnetic resonance imaging (MRI) of the cranial arteries, according to the 2021 American College of Rheumatology/Vasculitis Foundation guideline 1. Prompt treatment with high-dose corticosteroids, typically prednisone 40-60mg daily, is necessary to prevent vision loss and other complications, as suggested by the 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines 1 and the 2021 American College of Rheumatology/Vasculitis Foundation guideline 1.
From the Research
Symptoms of Temporal (Giant Cell) Arteritis
The symptoms of temporal (giant cell) arteritis include:
- Visual loss 2, 3, 4, 5, 6
- Headache, often described as pulsatile and located in the temporal regions 2, 3, 4, 5, 6
- Scalp tenderness 2, 3, 4, 6
- Jaw claudication 2, 3, 4, 5, 6
- Polymyalgia rheumatica, characterized by muscle pain 2, 3, 4, 6
- Anorexia 3
- Fever 3
- Diplopia and amaurosis fugax, which are visual symptoms 6
- Elevated erythrocyte sedimentation rate (ESR) is a common laboratory finding 5, 6
Severe Complications
Severe complications of temporal arteritis can include: