26420957
Descripción
Fichas por Jenna Paterson, actualizado hace más de 1 año
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Creado por Jenna Paterson
hace más de 3 años
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| Pregunta | Respuesta |
| What is temporal arteritis? | Temporal/giant cell arteritis is a systemic vasculitis that can affect both large and medium sized vessels. |
| What condition is temporal arteritis often associated with? | Polymyalgia rheumatica |
| Who classically gets temporal arteritis (sex and age) | Women >50 years |
| What causes visual symptoms in temporal arteritis? | Involvement of the extra cranial branches of the carotid artery (which supplies ophthalmic artery) |
| What are the signs and symptoms of temporal arteritis? | - Unilateral, localised headache over temporal area. - Tenderness/thickening/nodularity with associated redness of overlying skin. - Systemic features - Scalp tenderness - Intermittent jaw claudication - Eye symptoms - Neurological features - Peripheral arthritis/distal swelling/pitting oedema |
| What are the visual findings in temporal arteritis? | - Diplopia - Visual field defects - Changes to colour vision - A feeling of 'shade' covering one eye - Typically painless Permanent partial or complete loss of vision in one or both eyes occurs in up to 20% of people and is a common early symptom. If untreated, the second eye is likely to become affected within 1-2 weeks (but can be as early as 24h) Visual loss is permanent! |
| What are potential signs on fundoscopy of temporal arteritis? | Pallor and oedema of the optic disc Cotton wool patches Small haemorrhages in the retina |
| How can temporal arteritis be diagnosed? | - History - ESR and CRP elevated - Temporal artery USS - Halo sign - thickening of wall of affected vessels. - Temporal artery biopsy - may show presence of a mononuclear cell infiltration or granulomatous inflammation usually with multinucleated giant cells Other findings - LFTs (mild transaminitis), FBC (normocytic normochromic anaemia) |
| How is temporal arteritis managed? | Medical emergency - refer to rheumatology. If visual symptoms - oral prednisolone followed by IV methylprednisolone then longer course of oral steroids. If no visual symptoms - oral prednisolone Then gradual reduction in dose. Follow-up required. |
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