Intended for healthcare professionals

Rapid response to:

Clinical Review

Investigation and management of unintentional weight loss in older adults

BMJ 2011; 342 doi: (Published 29 March 2011) Cite this as: BMJ 2011;342:d1732

Rapid Response:

Weight loss and Giant Cell Arteritis

We were interested to read the comprehensive review of weight loss in
elderly people.

We have been impressed by the number of older people referred with
unexplained weight loss to our department who subsequently are found to
have Giant cell arteritis (Temporal arteritis). These patients may have
minimal symptoms and not have headache(1)but are at risk of visual loss
and permanent blindness. The Systemic nnflammatory disorders may only
represent 4% of patients with unexplained weight loss but this is a very
treatable condition with corticosteroids. If undiagnosed and/or untreated
there is high morbidity and mortality. We wish to bring to the attention
of your readers that connective tissue such as Giant cell arteritis may be
very insidious in onset and should be considered as part of the work-up in
a patient with weight loss. Inflammatory markers such as ESR and CRP may
be helpful although can be normal.

Ref: Arthritis and Rheumatism, June 1980 : L. A. Healey, K. Wiske :
Presentation of Occult giant cell arteritis

Competing interests: No competing interests

28 April 2011
S Shukla
R Hull, Consultant Rheumatologist
Rheumatology, Portsmouth Hospitals NHS Trust