Temporal arteritis- Pathology

Most common form of vasculitis. Affects females more than males. Primarily affects the elderly population. Temporal arteritis is associated with HLA-DR4

Distribution of the disease:
1. Small and medium sized arteries
2. Cranial arteries (temporal, facial and ophthalmic arteries)
2. Aortic arch-giant cell aortitis (uncommon)

Clinical features:
1. Throbbing headache- Mostly unilateral
2. Tender firm temporal arteries
3. Visual disturbances- Blurred vision, double vision, visual loss.
4. Facial pain
5. Fever, Malaise, Weight loss, muscle aches, anemia
6. Polymyalgia rheumatica: systemic flu like symptoms and joint involvement (pain, morning stiffness in neck, shoulders and hips).

Laboratory findings- Elevated ESR

Pathology-
1. Segmental granulomatous vaculitis
2. Fragmentation of internal elastic lamina
3. Intimal fibrosis with luminal narrowing.

Diagnosis-
Temporal arterial biopsy, classical presentation or rapid onset may be treated empirically

Treatment- Corticosteroids

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