temporal arteritis

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temporal arteritis2016-11-11T14:42:41+00:00

temporal arteritis

temporal arteritis image from New Medical Terms

low power H&E stained section of tissue with temporal arteritis

NEUROLOGY, PATHOLOGY

A self-limited condition that primarily affects middle-aged women, incidence 18:105/year, characterised by arterial vasculitis of the carotid artery which evolves to systemic arteritis in 10-15% of patients; blindness, strokes–which may occur as late complications. 

Clinical findings New-onset headache, scalp tenderness, jaw claudication, polymyalgia rheumatica

Diagnosis Temporal artery biopsy

Management High dose corticosteroids, tapered when possible 

Pathology–Macro Nodular transmural swelling of arteries

Pathology–Micro Active, changes are focal; classic giant cells are seen in 55%

• Early PMNs, eosinophils, medial necrosis, small arteriolar involvement

• Mid-phase Granulomas, mononuclear cells, fragmented internal elastic lamina

• Late (healed) Fibrotic replacement of > 1/4 IEL, patchy fibrosis of the interna and media, occasionally with neovascularisation

Synonyms Cranial arteritis, giant cell arteritis, granulomatous arteritis, Horton’s arteritis, Horton’s disease

Note: Whilst the term giant cell arteritis is more correct from a pathologic–and often a clinical–standpoint, temporal arteritis is widely preferred 

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