Giant Cell Arteritis and Takayasu Arteritis: Clinical Aspects, Diagnostics and Therapy

Giant cell arteritis (GCA) is the most common systemic vasculitis and affects large and medium-sized vessels. Takayasu arteritis (TA) is the second vasculitis of the large-sized vessels and affects young adults under 40 years of age. TA is the third most common vasculitis in children. Both vasculitides can cause ischaemic complications of extremities and visceral organs. The most common complication of GCA is ischaemia of the optic nerve causing irreversible blindness. Besides, dissection of aortic aneurysms, cerebral ischaemia, ischaemia of limbs or organs as well as tongue necrosis may occur. Diagnosis shoud be confirmed by biopsy or sonography but diagnostic procedures shoud not delay therapy. In addition, angiography is important as a diagnostic procedure in TA. In both large-sized vasculitides magnetic resonance angiography, computed tomography angiography, positron emission tomography and last but not least colour Dopler ultrasonography enable early diagnosis and the monitoring of responses to treatment. Corticosteroids are the therapy of choice in the treatment of GCA and TA. Disease-modifying drugs particularly methotrexate have a corticosteroid sparing effect in GCA. In contrast, TNF-blocking agents are effective in the treatment of TA.