[Prognosis of giant cell arteritis]

Abstract

The short-term prognosis of giant cell arteritis is associated to the risk of permanent visual loss, concerning 5-20% of patients, and mainly secondary to anterior ischaemic optic neuropathy. Most studies have suggested that long-term survival, around 80% at 5 years, is not impaired in giant cell arteritis. However, increased mortality has been often noticed in the year following diagnosis, especially related to cardiovascular disorders including aortitis (10-20% of cases), stroke (5-10% of cases), or myocardial infarction, commonly associated to atherosclerosis and to arterial hypertension. Aortic dissections or aneurysm ruptures are causes of death, which can therefore be directly related to the vasculitis. Most of the patients develop steroid related complications: infections that may lead to death, or osteoporosis in 20-40% of cases with a better prognosis than before thanks to preventive treatments.