Giant cell arteritis: diagnosing and treating inflammatory disease in older adults.

Giant cell arteritis (GCA), also known as temporal arteritis, cranial arteritis, or granulomatous arteritis, is a systemic necrotizing vasculitis seen in patients typically over age 50. If untreated, GCA can cause permanent visual loss in one or both eyes in 13% to 50% of patients. Primary care physicians routinely see elderly patients with headaches and fatigue; these may be potential symptoms of GCA. C-reactive protein (CRP) in conjunction with erythrocyte sedimentation rate (ESR) has 97% specificity in diagnosing GCA. Temporal artery biopsy confirms the diagnosis in many cases. Early recognition and treatment of this potentially blinding condition is thus essential. Systemic steroids are the standard therapy for patients with a positive diagnosis of GCA, and in a high percentage of patients the treatment may extend for more than one year.