Skip to main content Accessibility help
×
Home
  • Print publication year: 2008
  • Online publication date: January 2010

2 - TEMPORAL ARTERITIS

from PART I: - INFECTIOUS AND INFLAMMATORY CONDITIONS

Summary

Temporal (giant cell) arteritis is a systemic disease, involving various medium-sized and larger arteries, that occurs mostly in elderly patients. Blindness due to ischemic optic neuropathy is probably the most common and most feared sinister manifestation of the disease, but stroke is the leading cause of death in patients with temporal arteritis. Noninvasive angiography using computed tomography (CT) or magnetic resonance imaging (MRI) may reveal sites of vascular stenoses. A typical finding is smoothly tapered stenotic lesions different from the abrupt, irregular stenoses of atherosclerotic disease. These modalities may be helpful in assessing the extent of disease or potentially to aid diagnosis especially in biopsy negative cases. Fludeoxyglucose-positron emission tomography (FD-PET) scanning may reveal uptake in the larger thoracic vessels including aorta, subclavian, and carotid arteries. The mainstay of treatment is corticosteroids, although there is much debate about the optimal dose and use of steroid sparing immunosuppressives.

REFERENCES

Albert, D. M., Ruchman, M. C., and Keltner, J. L. 1976. Skip lesions in temporal arteritis. Arch Ophthalmol, 94, 2072–7.
Amor-Dorado, J. C., Llarca, J., Garcia-Porrua, C. et al. 2003. Audiovestibular manifestations in giant cell arteritis: a prospective study. Medicine, 82, 13–26.
Andersson, R., Malmvall, B. E., and Bengtsson, B. A. 1986. Acute phase reactants in the initial phase of giant cell arteritis. Acta Med Scand, 220, 365–7.
Beck, R. W., Cleary, P. A., Anderson, M. M., et al. 1992. A randomized, controlled trial of corticosteroids in the treatment of acute optic neuritis. The Optic Neuritis Study Group. N Engl J Med, 326, 581–8.
Bhatia, A., Ell, P. J., and Edwards, J. C. W. 2005. Anti CD-20 monoclonal antibody (Rituximab) as an adjunct in the treatment of giant cell arteritis. Ann Rheumatol Dis, 64, 1099–100.
Blockmans, D., Stroobants, S., Maes, A. et al. 2000. PET in giant cell arteritis and polymyalgia rheumatica: evidence for inflammation of the aortic arch. Am J Med, 108, 246–9.
Bogousslavsky, J., Deruaz, J. P., and Regli, F. 1985. Bilateral obstruction of internal carotid artery from giant cell arteritis and massive infarction limited to the vertebrobasilar area. Eur Neurol, 24, 57–61.
Calamia, K. T., and Hunder, G. G. 1981. Giant cell arteritis (temporal arteritis) presenting as fever of undetermined origin. Arthritis Rheumatol, 24, 1414–8.
Cantini, F., Niccoli, L., Salvarani, C., et al. 2001. Treatment of longstanding active giant cell arteritis with infliximab: report of 4 cases. Arthritis Rheumatol, 44, 2933–5.
Caselli, R. J. 1990. Giant cell (temporal arteritis): a treatable cause of multi-infarct dementia. Neurology, 40, 753–5.
Caselli, R. J., Daube, J. R., Hunder, G. G., and Whisnant, J. P. 1984. Peripheral neuropathic syndromes in giant cell arteritis. Ann Intern Med, 101, 594–7.
Caselli, R. J., Hunder, G. G., and Whisnant, J. P. 1988. Neurologic disease in biopsy proven giant cell (temporal) arteritis. Neurology, 38, 352–9.
Chan, C. C. K., and O’Day, J. 2003. Oral and intravenous steroids in giant cell arteritis. Clin Exp Ophthalmol, 31, 179–82.
Cockerham, K. P., Cockerham, G., Brown, H., and Hidayat, A. A. 2003. Radiosensitive orbital inflammation associated with temporal arteritis. J Neuroophthalmol, 23, 117–21.
Collazos, J., Garcia-Manco, C., Martin, A., Rodriguez, J., and Gomez, M. A. 1994. Multiple strokes after initiation of steroid therapy in giant cell arteritis. Postgrad Med J, 70, 228–30.
De Keyser, J., De Klippel, N., and Ebinger, G. 1991. Thrombocytosis and ischaemic complications in giant cell arteritis. BMJ, 303, 825.
Delecoeuillerie, G., Joly, P., Cohen de Lara A., and Paolaggi, J. B. 1988. Polymyalgia rheumatica and temporal arteritis: a retrospective analysis of prognostic features and different corticosteroid regimes (an 11-year survey of 210 patients). Ann Rheumatol Dis, 47, 733–9.
Espinosa, G., Tassies, D., Font, J., et al. 2001. Antiphospholipid antibodies and thrombophilic factors in giant cell arteritis. Semin Arthritis Rheumatol, 31, 12–20.
Esteban, M. J., Font, C., Hernandez-Rodriguez, J., et al. 2001. Small vessel vasculitis surrounding a spared temporal artery: clinical and pathological findings in a series of 28 patients. Arthritis Rheumatol, 44, 1387–95.
Evans, J. M., O’Fallon, W. M., and Hunder, G. G. 1995. Increased incidence of aortic aneurysm and dissection in giant cell (temporal) arteritis. A population-based study. Ann Intern Med, 122, 502–7.
Foroozan, R., Danesh-Meyer, H., Savino P., et al. 2002. Thrombocytosis in patients with biopsy proven giant cell arteritis. Ophthalmology, 109, 1267–71.
Franzen, P., Sutinen, S., and von Knorring, J. 1992. Giant cell arteritis and polymyalgia rheumatica in a region of Finland: an epidemiologic, clinical and pathological study, 1984–1988. J Rheumatol, 19, 273–6.
Ghanch, F. D., and Dutton, G. N. 1997. Current concepts in giant cell (temporal) arteritis. Surv Ophthalmol, 42, 99–123.
Gibb, W. R., Urry, P. A., and Lees, A. J. 1985.Giant cell arteritis with spinal cord infarction and basilar artery thrombosis. J Neurol Neurosurg Psychiatry, 48, 945–8.
Gillanders, L. A. 1969. Temporal arteriography. Clin Radiol, 20, 149–56.
Gonzalez-Gay, M. A., Blanco, R., Rodriguez-Valverde, V., et al. 1998. Permanent visual loss and cerebrovascular accidents in giant cell arteritis: predictors and response to treatment. Arthritis Rheumatol, 41, 1497–504.
Gonzalez-Gay, M. A., Garcia-Porrua, C., Pineiro, A., Pego-Reigosa R., Llorca J., and Hunder G. G. 2004. Aortic aneurysm and dissection in patients with biopsy proven giant cell arteritis from northwestern Spain: a population-based study. Medicine (Baltimore), 83, 335–41.
Goodman, B. W. 1979. Temporal arteritis. Am J Med, 67, 839–52.
Gran, J. T., Myklebust, G., Wilsgaard, T., and Jacobsen, B. K. 2001. Survival in polymyalgia rheumatica and giant cell arteritis: a study of 398 cases and matched population controls. Rheumatology (Oxford), 40, 1238–42.
Guevara, R. A., Newman, N. J., and Grossniklaus, H. E. 1998. Positive temporal artery biopsy 6 months after prednisolone treatment. Arch Ophthalmol, 116, 1252–3.
Hall, J. K., Volpe, N. J., Galetta, S. L., et al. 2003. The role of unilateral temporal artery biopsy. Ophthalmology, 110, 543–8.
Hayreh, S. S. 1981. Acute ischaemic optic neuropathy. Arch Neurol, 38, 675–8.
Hayreh, S. S., Podhajsky, P. A., Raman, R., and Zimmerman, B. 1997. Giant cell arteritis: validity and reliability of various diagnostic criteria. Am J Ophthalmol, 123, 285–96.
Hayreh, S. S., Podhajsky, P. A., and Zimmerman, B. 1998. Ocular manifestations of giant cell arteritis. Am J Ophthalmol, 125, 509–20.
Hayreh, S. S., and Zimmerman, B. 2003a. Management of giant cell arteritis: our 27-year clinical study: New light on old controversies. Ophthalmologica, 217, 239–59.
Hayreh, S. S., and Zimmerman, B. 2003b. Visual deterioration in giant cell arteritis patients while on high doses of corticosteroid therapy. Ophthalmology, 110, 1204–15.
Hayreh, S. S., Zimmerman, B., and Kardon, R. H. 2002. Visual improvement with corticosteroid therapy in giant cell arteritis: report of a large study and review of literature. Acta Ophthalmol Scand, 80, 355–67.
Hoffman, G. S., Cid, M. C., Hellman, D. B., et al. 2002. A multicenter, randomized, double-blinded, placebo controlled trial of adjuvant methotrexate treatment for giant cell arteritis. Arthritis Rheumatol, 46, 1309–18.
Horton, B. T., Mastath, B., and Brown, G. E. 1934. Arteritis of the temporal vessels. A previously undescribed form. Arch Intern Med, 53, 400–9.
Hunder, G. G. 2002. Epidemiology of giant cell arteritis. Cleve Clin J Med, 69(SII), 79–82.
Huston, K. A., Hunder, G. G., Lie, J. T., Kennedy, R. H., and Elveback, L. R. 1978. Temporal arteritis. A 25-year epidemiologic, clinical, and pathological study. Ann Intern Med, 88, 162–7.
Hutchinson, J. 1890. Diseases of the arteries. Arch Surg, 1, 323–33.
Islam, N., Asaria, R., Plant, G. T., and Hykin, P. C. 2003. Giant cell arteritis mimicking idiopathic orbital inflammatory disease. Eur J Ophthalmol, 13, 392–4.
Jover, J. A., Henandez-Garcia, C., Morado, I. C., et al. 2001. Combined treatment of giant cell arteritis with methotrexate and prednisolone. A randomized, double-blinded, placebo-controlled trial. Ann Intern Med, 134, 106–14.
Karassa, F. B., Matsasas, M. I., Schmidt, W. A., and Ioannidis, J. P. 2005. Meta-analysis: test performance of ultrasonography for giant cell arteritis. Ann Intern Med, 1212, 359–69.
Klein, R. G., Hunder, G. G., Stanson, A. W., and Sheps, S. G. 1975. Large artery involvement in giant cell (temporal) arteritis. Ann Intern Med, 83, 806–12.
Koorey, D. J. 1984. Cranial arteritis. A 20-year review of cases. Aust N Z J Med, 14, 143–7.
Lagrand, W. K., Hoogendoorn, M., Bakker, K., te Velde, J., and Labrie, A. 1996. Aortoduodenal fistula as an unusual and fatal manifestation of giant cell arteritis. Eur J Vasc Endovasc Surg, 11, 502–3.
Lie, J. T. 1990. Illustrated histopathological classification criteria for selected vasculitis syndromes. Arthritis Rheumatol, 33, 1074–87.
Machado, E. B. V., Michet, C. J., Ballard, D. J., et al. 1988. Trends in incidence and clinical presentation of temporal arteritis in Olmstead County, Minnesota, 1950–1985. Arthritis Rheumatol, 31, 745–9.
Mclean, C. A., Gonzales, M. F., and Dowling, J. P. 1993. Systemic giant cell arteritis and cerebellar infarction. Stroke, 24, 899–902.
Missen, G. A. K. 1972. Involvement of the vertebro-carotid arterial system in giant cell arteritis. J Pathol, 106, 2–3.
Morganstern, K. E., Ellis, B. D., Schochet, S. S., and Linberg, J. V. 2003. Bilateral optic nerve sheath enhancement from giant cell arteritis. J Rheumatol, 30, 625–7.
Neish, P. R., and Sergent, J. S. 1991. Giant cell arteritis. A case with unusual neurological manifestations and a normal sedimentation rate. Arch Intern Med, 151, 378–80.
Nesher, G., Berkun, Y., Mates, M., Baras, M., Rubinow, A., and Sonnenblick, M. 2004. Arthritis Rheumatol, 50, 1332–7.
Nesher, G., Rubinow, A., and Sonnenblick, M. 1997. Efficacy and adverse effects of different corticosteroid dose regimens in temporal arteritis: a retrospective study. Clin Exp Rheumatol, 15, 303–6.
Pavlica, P., Barozzi, L., Salvarani, C., Cantini, F., and Olivieri, I. 2000. Magnetic resonance imaging in the diagnosis of polymyalgia rheumatica. Clin Exp Rheumatol, 18, S38–9.
Peyo-Reigosa, R., Garcia-Porrua, C., Pineiro, A., et al. 2004. Predictors of cerebrovascular accident in giant cell arteritis in a defined population. Clin Exp Rheumatol, 22, S13–7.
Ray, J. G., Mamdani, M. M., and Geerts, W. H. 2005. Giant cell arteritis and cardiovascular disease in older adults Heart, 91, 324–8.
Redlich, F. C. 1993. A new medical diagnosis of Adolf Hitler. Giant cell arteritis: temporal arteritis. Arch Intern Med, 153, 693–7.
Reich, K. A., Giansiracusa, D. F., and Strongwater, S. L. 1990. Neurologic manifestations of giant cell arteritis. Am J Med, 89, 67–72.
Rucker, J. C., Biousse, V., and Newman, N. 2004. Ischaemic optic neuropathies. Curr Opin Neurol, 17, 27–35.
Ruegg, S., Engelter, S., Jeanneret, C. et al. 2003. Bilateral vertebral artery occlusion resulting from giant cell arteritis. Report of 3 cases and review of literature Medicine, 82, 1–12.
Salvarani, C., Cantini, F., Boiardi, L., and Hunder, G. G. 2002. Medical progress: polymyalgia rheumatica and giant cell arteritis. N Engl J Med, 347, 261–71.
Salvarani, C., and Hunder, G. G. 2001. Giant cell arteritis with low ESR: frequency of occurrence in a population-based study. Arthritis Rheumatol, 45, 140–5.
Salvarani, C., Silingardi, M., Ghirarduzzi, A. et al. 2002. Is duplex ultrasonography useful for the diagnosis of giant cell arteritis? Ann Intern Med, 137, 232–8.
Schmidt, D. 1994. Giant cell arteritis and Hitler. Arch Intern Med, 154, 930.
Smetana, G. W., and Shmerling, R. H. 2002. Does this patient have temporal arteritis? JAMA, 287, 92–101.
Spiera, R. F., Mitnick, H. J., Kupersmith, M., et al. 2001. A randomized, double-blinded, placebo controlled trial of methotrexate in the treatment of giant cell arteritis. Clin Exp Rheumatol, 19, 495–501.
Stanson, A. W. 2000. Imaging findings in extracranial (giant cell) temporal arteritis. Clin Exp Rheumatol, 18, S43–8.
Staunton, H., Stafford, F., Leader, M., and O’Riordain, D. 2000. Deterioration of giant cell arteritis with corticosteroid therapy. Arch Neurol, 57, 581–4.
Tan, A. L., Holdsworth, J., Pease, C., Emery, P., and McGonagle, D. 2003. Successful treatment of resistant giant cell arteritis with etanercept. Ann Rheumatol Dis, 62, 373–4.
Thal, D. R., Barduzal, S., Franz, K., et al. 2001. Giant cell arteritis in a 19-year-old woman associated with vertebral artery aneurysm and subarachnoid haemorrhage. Clin Neuropathol, 20, 80–6.
To, K. W., Enzer, Y. R., and Tsiaras, W. G. 1994. Temporal artery biopsy after 1 month of corticosteroid therapy. Am J Ophthalmol, 117, 265–7.
Weyand, C. M., Fulbright, J. W., Hunder, G. G., Evans, J. M., and Goronzy, J. J. 2000. Treatment of giant cell arteritis: interleukin-6 as a biological marker of disease activity. Arthritis Rheumatol, 43, 1041–8.
Weyand, C. M., and Goronzy, J. J. 2003. Giant cell arteritis and polymyalgia rheumatica. Ann Intern Med, 139, 505–15.
Wilkinson, I. M. S., and Ross Russell, R. W. 1972. Arteries of the head and neck in giant cell arteritis. A pathological study to show the patterns of arterial involvement. Arch Neurol, 27, 378–91.