Giant Cell Arteritis

Giant cell arteritis is diagnosed and treated by the Rheumatology Division of Premier Medical Group.

What is giant cell arteritis?

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Also known as temporal arteritis, giant cell arteritis is the most common form of vasculitis in older adults. The condition primarily affects people who are over the age of 50. Giant cell arteritis is a blood vessel disease that causes swelling and thickening of the small artery under the skin in the head and neck, known as the temporal artery. This interrupts blood flow, which can cause persistent headache, fatigue, fevers, and flu-like symptoms. When left untreated, giant cell arteritis can lead to blindness.

Giant cell arteritis typically occurs alongside a different form of vasculitis called polymyalgia rheumatica. Both are autoimmune diseases, which means that they occur as the result of an immune system attack. The pain associated with this condition can be severe, and most treatment methods focus on symptom mitigation.

What are the symptoms of giant cell arteritis?

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The symptoms of giant cell arteritis change over time, but the condition most often begins with a persistent headache, typically around the temples. People with giant cell arteritis can then develop fatigue, loss of appetite, a flu-like feeling, and weight loss. As the condition progresses, you may experience jaw pain, tongue and throat pain, and double vision. In the most severe cases, permanent blindness can occur.

You’ll notice that these symptoms are also characteristic of other conditions, which makes giant cell arteritis notoriously difficult to catch. If you are worried about any possible symptoms, the best thing to do is to visit a doctor.

Pain and stiffness experienced in the neck, hips, and/or shoulders may also be associated with polymyalgia rheumatica, a related disorder. Close to 50 percent of people diagnosed with giant cell arteritis also have polymyalgia rheumatica, so it is important to communicate any symptom overlap to your doctor.

What causes giant cell arteritis?

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Doctors don’t know the exact cause of giant cell arteritis, but they think aging has something to do with the disease’s onset and progression. In all cases of giant cell arteritis, an unknown trigger causes the immune system to attack and inflame the arteries. Certain genetic factors and environmental conditions can increase your risk of developing giant cell arteritis, but there are no known, widespread triggers.

Interestingly, Caucasian women over the age of 50 are at the highest risk of developing the condition. If you fit into this category and are experiencing giant cell arteritis symptoms, contact your doctor.

How is giant cell arteritis diagnosed?

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There are several temporal arteritis tests a doctor may conduct to understand whether you have the condition. In all cases, they will begin with a physical exam. This will involve looking at and feeling the head to determine any tenderness. Your doctor may also order a blood test to understand the amount of hemoglobin and the number of red blood cells therein. Other common tests include a liver function test, which will determine how well the liver is working, erythrocyte sedimentation rate tests, which can assess inflammation, and a C-reactive protein test, which can assess a different measure for bodily inflammation.

Doctors may also order certain imaging tests to get a better view into the extent of the inflammation. These tests may include a doppler ultrasound, which can produce images of blood flow, magnetic resonance angiography, which can provide images of blood vessels, and positron emission tomography, which can produce highly detailed images of larger blood vessels.

In most cases, a blood or imaging test alone is not enough to provide a definitive diagnosis. If a doctor strongly suspects that you have giant cell arteritis, they will likely order a biopsy of the affected artery. Ultrasounds can also provide information regarding temporal inflammation. The diagnostic process can be long and difficult, but it is essential to receive the care you need.

What is the treatment for giant cell arteritis?

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Like most autoimmune disorders, there is no cure for giant cell arteritis. Instead, temporal arteritis treatment focuses on symptom control and alleviation. Most strategies target damaged tissue and work to alleviate inflammation that hinders blood flow. The best treatment for giant cell arteritis includes glucocorticoids, like oral prednisone. For the majority of patients, this also includes using corticosteroids.

However, corticosteroids come with their own side effects. The drugs can increase a person’s risk of developing osteoporosis, glaucoma, cataracts, and high blood pressure, and they may cause weight gain, increased bruising, increased blood sugar levels, and decreased immune system function. It is important to talk to your doctor about potential treatment options and how they may affect your body.

What are the common complications with giant cell arteritis?

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As with many autoimmune conditions, giant cell arteritis can cause complications. The condition is associated with an increased risk of dementia. Additionally, giant cell arteritis can cause strokes, frequently prompting most patient’s first-ever strokes. Patients may also become permanently blind and experience an aortic aneurysm.

Other complications may arise from overuse of anti-inflammatory drugs prescribed by your doctor. In many cases, you will remain on a specific treatment plan for several months or years, then slowly wean yourself off a particular medication. This can help to prevent the most severe side effects from taking root.