HNY Policy and Pathway Repository - North Yorkshire

Giant cell arteritis pathway

None provided

PLEASE NOTE:​ ONLY REFER TO RHEUMATOLOGY IF CRP >5​

If CRP normal and GP still has concerns, please contact for advice:​

Telephone: 01423 553389​
Email: hdft.rheumatology.secretaries@nhs.net​

​

Refer for GCA pathway if meets all of the below criteria:

• Age >50​ (Most >65​ Rare in non-Caucasians)​
• Symptoms of GCA
  • New type of headache (“head pain”)​
  • Scalp tenderness​
  • Jaw or tongue claudication​
  • Visual (amaurosis fugax,double vision)​
  • Limb claudication​
  • Abnormal temporal artery​
  • Often in conjunction with:​
    • PMR​
    • Systemic upset​
• Subacute/acuteonset​

• CRP >5 ​(EXCEPT for patients with VISUAL symptoms, WHEN CRP CAN BE NORMAL)​ Bloods must be taken prior to steroids​.

New visual symptoms esp partial/completevisual loss/amaurosis fugax/diplopia​

• 60mg Prednisolone​
• Urgent ophthalmology referral​
  9-5 pm mon - Fri ; ophthalmology triage Tel no 01423 54 2217 , ​
  HDFT ophth urgent referral email address; hdft.eyereferrals@nhs.net​
  Out of hours/ bank holidays - please contact on call via switchboard ​

Everyone else​

• 40mg Prednisolone​
• 60mg if jaw claudication​
• Urgent rheumatology referral​
  • Rheumatology contact:​
    Please email referral AND ask secretaries to confirm referral received AND refer via eRS. If no confirmation reply of referral then please call.
    Telephone: 01423 553389​
    Email: hdft.rheumatology.secretaries@nhs.net​
    ​If out of hours (4pm-8am or weekends), please contact the next working day to check referral has been received. DO NOT delay treatment pending referral receipt confirmation​

• Harrogate and District