Clinical practice. Giant-cell arteritis and polymyalgia rheumatica

N Engl J Med. 2014 Jul 3;371(1):50-7. doi: 10.1056/NEJMcp1214825.


A 79-year-old woman presents with new-onset pain in her neck and both shoulders. She takes 7.5 mg of prednisone per day for giant-cell arteritis. Occipital tenderness and diplopia developed 11 months before presentation. At that time, her erythrocyte sedimentation rate was elevated, at 78 mm per hour, and a temporal-artery biopsy revealed granulomatous arteritis. The diplopia resolved after 6 days of treatment with 60 mg of prednisone daily. Neither headache nor visual symptoms developed when the glucocorticoids were tapered. How should this patient’s care be managed?

Publication types

  • Review

MeSH terms

  • Aged
  • Diplopia / etiology
  • Female
  • Giant Cell Arteritis* / complications
  • Giant Cell Arteritis* / diagnosis
  • Giant Cell Arteritis* / drug therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Polymyalgia Rheumatica* / complications
  • Polymyalgia Rheumatica* / diagnosis
  • Polymyalgia Rheumatica* / drug therapy


  • Immunosuppressive Agents