- Temporal Arteritis
- Chronic systemic condition involving vasculitis of large and medium-sized arteries – Large Artery Vasculitis
Incidence
- F > M 2:1, average age at presentation 75yrs
Clinical
- Unilateral headache
- Tender temporal artery + nodular change
- Jaw claudication
- 50% have PMR
- Visual change > 50%
- Retinal artery occlusion
- Ischaemic optic neuritis
Pathology
- Inflammation of temporal, vertebral, ophthalmic, aortic arch (90% = branches of ECA)
- Histology: fragmentation of internal elastic lamina with mononuclear cell infiltration and accumulation of giant cells; skip lesions
Investigations
- ESR
- Temporal Artery biopsy
- At least 20mm in length
- Performed within 2/52 of starting steroids (Inflammatory changes probably persist 2-4/52)
Management
- High dose steroids: start at 60mmHg → Then taper