Editing Giant cell arteritis (section)

==Signs and symptoms==
Common symptoms of giant cell arteritis include:
* [[bruit]]s
* [[fever]]
* [[headache]]<ref name="pmid18711459">{{cite journal | vauthors = Moutray TN, Williams MA, Best JL | title = Suspected giant cell arteritis: a study of referrals for temporal artery biopsy | journal = Canadian Journal of Ophthalmology | volume = 43 | issue = 4 | pages = 445–448 | date = August 2008 | pmid = 18711459 | doi = 10.3129/i08-070 }}</ref>
* tenderness and sensitivity on the [[scalp]]
* [[jaw claudication]] (pain in jaw when chewing)
* [[tongue]] [[claudication]] (pain in tongue when chewing) and [[necrosis]]<ref>{{cite journal | vauthors = Sainuddin S, Saeed NR | title = Acute bilateral tongue necrosis--a case report | journal = The British Journal of Oral & Maxillofacial Surgery | volume = 46 | issue = 8 | pages = 671–672 | date = December 2008 | pmid = 18499311 | doi = 10.1016/j.bjoms.2008.03.027 }}</ref><ref name="pmid21176820">{{cite journal | vauthors = Zadik Y, Findler M, Maly A, Rushinek H, Czerninski R | title = A 78-year-old woman with bilateral tongue necrosis | journal = Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics | volume = 111 | issue = 1 | pages = 15–19 | date = January 2011 | pmid = 21176820 | doi = 10.1016/j.tripleo.2010.09.001 | doi-access = free }}</ref>
* reduced [[visual acuity]] (blurred vision)
* acute [[visual loss]] (sudden blindness)
* [[diplopia]] (double vision)
*limb [[claudication]]<ref>{{cite journal | vauthors = Walz-Leblanc BA, Ameli FM, Keystone EC | title = Giant cell arteritis presenting as limb claudication. Report and review of the literature | journal = The Journal of Rheumatology | volume = 18 | issue = 3 | pages = 470–472 | date = March 1991 | pmid = 1856819 | url = https://pubmed.ncbi.nlm.nih.gov/1856819 }}</ref>
* [[polymyalgia rheumatica]] (in 50%)<ref name=half>{{cite web| vauthors = Hunder GG |title=Polymyalgia rheumatica and giant cell (temporal) arteritis|url=http://www.uptodate.com/contents/polymyalgia-rheumatica-and-giant-cell-temporal-arteritis-beyond-the-basics?view=print|website=uptodate.com|publisher=Wolters Kluwer|access-date=23 September 2015|url-status=live|archive-url=https://web.archive.org/web/20150925110253/http://www.uptodate.com/contents/polymyalgia-rheumatica-and-giant-cell-temporal-arteritis-beyond-the-basics?view=print|archive-date=25 September 2015}}</ref>

The inflammation may affect blood supply to the [[Human eye|eye]]; blurred vision or sudden [[blindness]] may occur. In 76% of cases involving the eye, the [[ophthalmic artery]] is involved, causing [[arteritic anterior ischemic optic neuropathy]].<ref>{{cite web |author=Hayreh |title=Ocular Manifestations of GCA |url=http://webeye.ophth.uiowa.edu/dept/GCA/04-ocular.htm |date=April 3, 2003 |publisher=University of Iowa Health Care |access-date=2007-10-15 |url-status=dead |archive-url=https://web.archive.org/web/20071025074136/http://webeye.ophth.uiowa.edu/dept/GCA/04-ocular.htm |archive-date=2007-10-25 }}</ref>

Giant cell arteritis may present with atypical or overlapping features.<ref name="ranasaeed">{{cite journal | vauthors = Rana AQ, Saeed U, Khan OA, Qureshi AR, Paul D | title = Giant cell arteritis or tension-type headache?: A differential diagnostic dilemma | journal = Journal of Neurosciences in Rural Practice | volume = 5 | issue = 4 | pages = 409–411 | date = October 2014 | pmid = 25288850 | pmc = 4173245 | doi = 10.4103/0976-3147.140005 | doi-access = free }}</ref> Early and accurate diagnosis is important to prevent ischemic vision loss. Therefore, this condition is considered a [[medical emergency]].<ref name=ranasaeed />

While studies vary as to the exact [[relapse]] rate of giant cell arteritis, relapse of this condition can occur.<ref name=":3" /> It most often happens at low doses of prednisone (<20&nbsp;mg/day), during the first year of treatment, and the most common signs of relapse are headache and [[polymyalgia rheumatica]].<ref name=":3">{{Cite web|url=https://www.uptodate.com/contents/treatment-of-giant-cell-arteritis?source=history_widget#references|title=UpToDate|website=www.uptodate.com|access-date=2019-11-25}}</ref>

===Associated conditions===
The [[varicella-zoster virus]] (VZV) [[antigen]] was found in 74% of temporal artery biopsies that were GCA-positive, suggesting that the VZV infection may trigger the inflammatory cascade.<ref>{{cite journal | vauthors = Gilden D, White T, Khmeleva N, Heintzman A, Choe A, Boyer PJ, Grose C, Carpenter JE, Rempel A, Bos N, Kandasamy B, Lear-Kaul K, Holmes DB, Bennett JL, Cohrs RJ, Mahalingam R, Mandava N, Eberhart CG, Bockelman B, Poppiti RJ, Tamhankar MA, Fogt F, Amato M, Wood E, Durairaj V, Rasmussen S, Petursdottir V, Pollak L, Mendlovic S, Chatelain D, Keyvani K, Brueck W, Nagel MA | title = Prevalence and distribution of VZV in temporal arteries of patients with giant cell arteritis | journal = Neurology | volume = 84 | issue = 19 | pages = 1948–1955 | date = May 2015 | pmid = 25695965 | pmc = 4433460 | doi = 10.1212/WNL.0000000000001409 }}</ref>

The disorder may co-exist (in about half of cases) with [[polymyalgia rheumatica]] (PMR),<ref name="half" /> which is characterized by sudden onset of pain and stiffness in muscles ([[pelvis]], [[shoulder]]) of the body and is seen in the elderly. GCA and PMR are so closely linked that they are often considered to be different manifestations of the same disease process. PMR usually lacks the [[Skull|cranial]] symptoms, including headache, pain in the jaw while chewing, and vision symptoms, that are present in GCA.<ref>{{Cite web|url=https://bestpractice.bmj.com/topics/en-gb/177/differentials|title=Giant cell arteritis|website=BMJ Best Practice|access-date=2019-11-25}}</ref>

Giant cell arteritis can affect the aorta and lead to [[aortic aneurysm]] and [[aortic dissection]].<ref name=":0" /> Up to 67% of people with GCA having evidence of an inflamed aorta, which can increase the risk of aortic aneurysm and dissection.<ref name=":0">{{cite journal | vauthors = Chen JJ, Warrington KJ, Garrity JA, Prasad S | title = Is Routine Imaging of the Aorta Warranted in Patients With Giant Cell Arteritis? | journal = Journal of Neuro-Ophthalmology | volume = 37 | issue = 3 | pages = 314–319 | date = September 2017 | pmid = 28614098 | doi = 10.1097/WNO.0000000000000538 | s2cid = 3747982 }}</ref> There are arguments for the routine screening of each person with GCA for this possible life-threatening complication by imaging the aorta. Screening should be done on a case-by-case basis based on the signs and symptoms of people with GCA.<ref name=":0" />