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Clinical manifestations of giant cell (temporal) arteritis

William P Docken, MD
James T Rosenbaum, MD
Section Editors
Jonathan Trobe, MD
Gene G Hunder, MD
Deputy Editor
Monica Ramirez Curtis, MD, MPH


Giant cell arteritis (GCA) is categorized as a vasculitis of large- and medium-sized vessels. GCA is designated as a vasculitis of this caliber because it can involve the aorta and great vessels, and because it shares some histopathologic features with Takayasu arteritis, the other major “large vessel” vasculitis. Systemic symptoms are common in GCA and vascular involvement can be widespread. However, it is the targeting of the tiny muscular arteries from cranial branches of the aortic arch that gives rise to many of the most characteristic symptoms of GCA. The most feared complication of GCA, visual loss, is one potential consequence of such cranial arteritis.

The clinical manifestations of GCA will be reviewed here. The pathogenesis, diagnosis, and treatment of this disorder are discussed separately. (See "Pathogenesis of giant cell (temporal) arteritis" and "Diagnosis of giant cell (temporal) arteritis" and "Treatment of giant cell (temporal) arteritis".)


Giant cell arteritis (GCA) is the most common systemic vasculitis [1]. In the United States population, the lifetime risk of developing GCA has been estimated at approximately 1 percent in women and 0.5 percent in men [2].

The greatest risk factor for developing GCA is aging. The disease almost never occurs before age 50, and its incidence rises steadily thereafter, peaking between the ages of 70 to 79 [3], with over 80 percent of patients older than 70 years of age [4,5]. One study found the mean age at incidence of GCA to be 76.7 years [6].

In addition to age, ethnicity is a major risk factor for GCA. The highest incidence figures are found in Scandinavian countries and among Americans of Scandinavian descent. The annual incidence of GCA in Olmsted County, Minnesota is 17 per 100,000 persons over the age of 50, similar to that in Scandinavian countries [3]. This similarity probably reflects shared genetic risk factors, as many of the inhabitants of Olmsted County during the period of study were descended from Scandinavians and northern Europeans. In Southern Europe and Mediterranean countries incidence rates are lower, with less than 10 per 100,000 persons over the age of 50 [5,7,8]. GCA is unusual in Latinos, Asians, and Arabs, though formal data on these populations are scant. The disease is decidedly uncommon in African Americans [9].


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Literature review current through: Sep 2016. | This topic last updated: Sep 6, 2016.
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