Giant cell arteritis

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Giant cell arteritis
Illustration of the temporal artery
Synonyms	Temporal arteritis, cranial arteritis
Pronounce
Specialty	Rheumatology
Symptoms	Headache, jaw claudication, vision loss, scalp tenderness, fever, fatigue
Complications	Blindness, aortic aneurysm, stroke
Onset	Typically >50 years old
Duration
Types
Causes	Unknown, possibly autoimmune
Risks	Polymyalgia rheumatica, age >50, female sex
Diagnosis	Temporal artery biopsy, ultrasound, MRI
Differential diagnosis	Polymyalgia rheumatica, Takayasu's arteritis, migraine, tension headache
Prevention
Treatment	Corticosteroids, methotrexate, tocilizumab
Medication
Prognosis	Good with treatment, risk of complications if untreated
Frequency	15-30 per 100,000 people over 50 years old
Deaths	Rare with treatment

Giant cell arteritis (GCA), also known as temporal arteritis and cranial arteritis, is an inflammatory disease of blood vessels. Most commonly, it affects the arteries of the head, especially those in the temples. For this reason, it is often called temporal arteritis. If the disease is not treated, it can lead to blindness or stroke.

Symptoms

The most common symptoms of giant cell arteritis are head pain and tenderness — often severe — that usually affects both temples. Other signs and symptoms, which can occur suddenly, include:

• Pain and stiffness, often in the neck, shoulders or hips
• Fatigue
• Loss of appetite
• Fever
• Unintended weight loss
• Vision loss or double vision, particularly in one eye
• Scalp tenderness
• Jaw pain or jaw claudication
• Sweating
• Joint pain
• Muscle pain

Causes

The exact cause of giant cell arteritis is unknown. It is thought that a combination of genetic and environmental factors, such as infections, play a role. The condition is related to an abnormal immune response.

Diagnosis

Diagnosis of giant cell arteritis can be difficult because the symptoms are similar to those of other conditions. However, a biopsy of the temporal artery can confirm the diagnosis. Other tests, such as blood tests and imaging studies, may also be used.

Treatment

Treatment for giant cell arteritis involves high doses of a corticosteroid drug such as prednisone. Because of the risk of vision loss, treatment typically begins as soon as the disease is suspected, even before a diagnosis is confirmed.

Prognosis

With early diagnosis and treatment, the prognosis for people with giant cell arteritis is generally good. However, relapses are common and long-term medication may be needed.

See also

• Polymyalgia rheumatica
• Vasculitis
• Rheumatology

References

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