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Giant cell arteritis - (GCA)

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Screening and diagnosis

GCA can be difficult to diagnose because its early symptoms resemble those of many common conditions. For that reason, your doctor will try to rule out other possible causes of your problem.

In addition to asking about your symptoms and past medical history, your doctor is likely to perform a thorough physical exam, paying particular attention to your temporal arteries. In about half of all people with GCA, one or both of these arteries are tender, with a reduced pulse and a hard, cord-like feel and appearance.

To help diagnose GCA, you also may have some of the following tests:

  • Blood tests. If your doctor suspects GCA, you're likely to have a blood test that checks your erythrocyte sedimentation rate - commonly referred to as the sed rate. This test measures how quickly red blood cells fall to the bottom of a tube of blood. Red cells that drop rapidly may indicate inflammation in your body. You also may have a test that measures C-reactive protein (CRP), a substance your liver produces when inflammation is present. The same tests may be used to follow your progress during treatment.

  • Cerebral angiogram. In some cases, you may need a more invasive X-ray test called a cerebral angiogram. During this procedure, a flexible tube (catheter) resembling a strand of spaghetti is inserted into a large artery — usually in your groin — and threaded past your heart into the cerebral arteries in your brain. A special dye (contrast medium) is then injected into the catheter and X-rays are taken as the dye fills these arteries. The test takes about an hour, and you'll need to rest in bed for a few hours afterward. A cerebral angiogram provides a clear picture of the arterial blood flow in your head, but the procedure isn't without risks, including bleeding at the catheter insertion site, infection and stroke.

  • Biopsy. Although blood tests and cerebral angiography can provide your doctor with useful information, the only way to confirm a diagnosis of GCA is by taking a small sample (biopsy) of the temporal artery. Because the inflammation may not occur in all parts of the artery, more than one sample may be needed. The procedure is performed on an outpatient basis under local anesthesia, usually with little discomfort or scarring. The sample is examined under a microscope in a laboratory. If you have GCA, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name.

  • Unfortunately, a biopsy isn't foolproof. It's possible to have GCA and still have a negative biopsy result. If the results aren't clear, your doctor may advise a biopsy on the other side of your head.


The most serious complication of GCA is sudden, painless vision loss in one or, in rare cases, both eyes. Unfortunately, blindness is usually permanent. Other rare but possible complications of GCA include:

  • Aortic aneurysm. An aneurysm is a bulge in a blood vessel. It can develop in a blood vessel anywhere in your body, but most aneurysms occur in the aorta, the large artery that runs down the center of your chest and abdomen. Aneurysms that develop in the part of the aorta that runs through the abdomen are called abdominal aortic aneurysms. Those that occur in the upper chest are known as thoracic aortic aneurysms. An aortic aneurysm is considered a serious condition because it may burst, causing massive and life-threatening internal bleeding. Having giant cell arteritis doubles your risk of aneurysm, which may even occur years after the initial diagnosis.

  • Stroke. This serious condition is an uncommon complication of GCA. It occurs when interrupted blood flow deprives part of your brain of necessary oxygen and nutrients.

  • Chest pain (angina). In rare cases, some people with GCA have chest pain. This can result from inflammation in the coronary arteries that supply your heart with oxygen and nutrients.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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