CDHB
GCA is an infrequent association of polymyalgia rheumatica. Biopsy evidence of GCA may occur in up to 1:20 patients. However patients may present with sudden blindness without prodrome in which case the acute phase markers may not be elevated. Immediate treatment with high dose prednisone is important in reducing the high incidence of blindness developing in the other eye. Temporal artery biopsy is strongly recommended but can be delayed for up to 5-7 days without substantially hindering histological interpretation. Steroid regimen is empirical; a common regimen is prednisone 40-60 mg/day for 1 month, 30-40 mg 1 month, 20-30 mg 1 month, 15-20 mg 1 month, 12.5-15 mg 1 month, then as for PMR (or slower). Most patients require treatment for 2yrs minimum hence importance of osteoporosis prophylaxis.
Topic Code: 3745