Arterial biopsy of elderly male shows fragmentation of elastic lamina, lymphocyte infiltration and giant cells -

Ans. is 'a' i.e., Temporal arteritis Giant cell arteritis or temporal arteritiso It is the most common form of systemic vasculitis in adults,o It is an acute and chronic, often granulomatous inflammation of arteries of large to small size,o Giant cell arteritis affects principally the arteries in the head, especially the temporal arteries which is the extracranial branch of carotid artery,o Vertebral and ophthalmic arteries may also be involved.o Segment of affected artery develops nodular thickening with narrowing of lumen.o There is granulomatous inflammation in the vessel wall with foreign body and Langhans type multinucleated giant cells and fragmentation of internal elastic lamina.Presentation of Giant cell arteritiso Constitutional symptomsMost common nonspecific symptomsInclude malaise, fatigue, anorexia and weight loss.These symptoms are due to generalized involvement of the body and are not related to any organ involvement,o HeadacheIt is most common vasculitis related symptom.Most commonly over temporal region,o Jaw claudicationIt is most specific symptom of GCA.It is manifested as pain in masseter when eating food that require vigorous chewing because oxygen demand of the masseter exceeds the supply provided by narrowed and inflamed arteries.o Visual symptomsDiplopia and visual loss.Ophthalmic artery involvement can lead to sudden blindness which is the most feared complication of GCA.o Polymylagia rheumaticaAching and stiffness of the shoulder, neck and lip girdle area,o Arthritiso Raised ESRo Normocytic - Normochromic anemia