Large-vessel vasculitis: giant cell vs Takayasu
- Lesion
Two granulomatous diseases of the aorta and its branches: one strikes the head arteries of older adults, the other the aortic arch of young women.
What it is
Giant cell arteritis and Takayasu arteritis are T-cell mediated granulomatous inflammations of large arteries with almost the same histology; age and distribution separate them. Giant cell arteritis is the commonest vasculitis of older adults and affects branches of the carotid (temporal, ophthalmic, vertebral) and the aorta; it can cause sudden blindness. Takayasu arteritis affects the aortic arch and its branches in younger people, mainly women, narrowing the arteries of the arms.
Structure
- Giant cell arteritis: intimal thickening narrowing the lumen; granulomas with multinucleated giant cells at the internal elastic lamina, which is fragmented; sometimes only a non-specific lymphocytic panarteritis.
- Takayasu: early mononuclear inflammation around the vasa vasorum and granulomas in the media; later dense fibrosis of media and adventitia; irregular thickened aortic intima (tree-bark).
Giant cell arteritis versus Takayasu arteritis
| Disease | Who | Arteries and signs |
|---|---|---|
| Giant cell arteritis | Over 50; more women | Carotid branches (temporal, ophthalmic, vertebral) and aorta: headache, jaw claudication, sudden blindness; polymyalgia rheumatica |
| Takayasu arteritis | Under 50; mostly young women | Aortic arch and branches, renal and pulmonary arteries: weak arm pulses, unequal pressures, claudication of the arms |
Clinical notes
- Giant cell arteritis is an emergency because ophthalmic artery involvement can cause permanent blindness; treatment is started before the biopsy result.
- Large-vessel imaging shows that giant cell arteritis often involves the aorta too, with later aneurysm risk.
Test yourself
Think of the answer, then tap the question to see it.
Why can a temporal artery biopsy be falsely negative in giant cell arteritis?
Because the inflammation is segmental (skip lesions), so a short biopsy can miss it.
Which complication makes giant cell arteritis an emergency?
Sudden, permanent visual loss from ophthalmic or posterior ciliary artery involvement.
Why is Takayasu arteritis called ‘pulseless disease’?
Narrowing of the subclavian and other arch branches weakens or abolishes the pulses of the arms.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Giant Cell Arteritis (Temporal Arteritis) (StatPearls (NCBI Bookshelf), 2025); Takayasu arteritis: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2025).
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Representative model, for educational purposes only.