An inflammation of the artery lining is called giant cell arteritis. In most cases, it negatively affects the arteries located in the head (especially in the temples). Healthcare professionals sometimes call this condition temporal arteritis. The most common symptoms of giant cell arteritis include scalp tenderness, jaw pain, vision problems, and headaches. If it is left untreated even blindness may occur.
Early diagnosis and proper treatment, can lessen the symptoms and may prevent blindness. Usually, people begin to feel better within a few days after starting the treatment. However, this condition may relapse even with treatment. The primary treatment option for people with giant cell arteritis is corticosteroid medicines. Moreover, it is advised to have regular checkups with your doctor because these medicines can cause serious adverse reactions.
Symptoms
The most common giant cell arteritis symptoms include head pain and tenderness that often are severe. Moreover, head pain usually gradually worsens over time. Check below other symptoms:
- Vision problems (including double vision and others)
- Fever
- Extreme tiredness (fatigue)
- Jaw pain, especially when open mouth wide or chew
- Scalp tenderness
- Sudden and permanent vision loss in one eye
Stiffness and pain in the shoulders, neck, or hips due to polymyalgia rheumatic. Approximately 50% of people with giant cell arteritis also have a previous condition.
If you experience severe head pain or any of the previous symptoms for long periods, you should see a doctor immediately.
Causes
Inflammation of the lining of the arteries causes them to swell in people with this condition. As a result, it leads to the narrowing of the blood vessels which decreases blood flow as well as nutrients and oxygen that the body requires for normal functioning. Furthermore, roughly all large or medium arteries are affected but inflammation frequently occurs in the temple arteries.
Experts do not know the exact cause of why arteries linings become inflamed but they think there is an attack of the immune system. However, certain genes and environmental factors could play a role.
Risk Factors
The following factors may elevate your risk of developing this condition. For example:
- Age – In most cases, giant cell arteritis occurs in people over 50 years old and symptoms often appear between 70 and 80 years old.
- Sex – Females are more likely to develop this condition than males.
- Geographic region and race – Those who are of Scandinavian descent and white people in Northern Europe more commonly experience this condition.
- Polymyalgia rheumatica – People with this condition are at higher risk of developing giant cell arteritis.
- Family history – In some cases, this condition may run in families.
What Are The Possible Complications of Giant Cell Arteritis?
If you do not get treatment for this condition, it may lead to serious complications. These include:
- Aortic aneurysm – People with weakened blood vessels frequently experience a bulge (aneurysm) in these blood vessels. Thus, there is an increased risk of aortic aneurysm burst, which causes life-threatening internal bleeding. That’s why doctors recommend annual tests to check the aorta after giant cell arteritis occurs.
- Stroke – This complication occurs quite rarely.
- Blindness – Reduced blood flow may cause sudden vision loss in one or both eyes (rarely). Unfortunately, once it occurs it cannot be reversed.
Diagnosis
Diagnosing giant cell arteritis may be difficult because it causes similar symptoms to other common health problems. Therefore, doctors will perform several tests that help to confirm the condition and exclude others that cause similar symptoms. Furthermore, physicians will perform a physical examination to check for temporal artery abnormalities and ask questions about symptoms and your medical history. Check below some tests usually involved in giant cell arteritis diagnosis:
Blood Tests
The following blood tests are usually done to confirm the condition and monitor the progress during treatment. Examples include:
- Erythrocyte sedimentation rate – This is a quick test that measures red blood cells, which can indicate inflammation in the body.
- C-reactive protein (CRP) – This test measures the amount of substance produced by the liver in high amounts when inflammation is present.
Imaging Tests
The following tests help monitor your response to treatment. For example:
- MRA (magnetic resonance angiography) – This test is a combination of MRI and a contrast material that helps get detailed images of the blood vessels.
- Positron emission tomography (PET) – Healthcare professionals usually perform this test when they suspect giant cell arteritis occurs in large arteries (such as the aorta). It involves a small amount of radioactive material that is given intravenously before scanning. It helps get more accurate images of the large blood vessels.
- Doppler ultrasound – This test helps doctors get images of blood flowing through blood vessels.
Biopsy
One of the best ways to diagnose giant cell arteritis is by biopsy. This is a procedure in which doctors get a small sample of the temporal artery and send it for testing in a laboratory. Temporal artery biopsy is usually performed with local anesthesia. If you have this condition doctors will notice large or giant cells in that artery. In addition, sometimes, you may have this condition but a biopsy shows negative outcomes. In such cases, doctors will try to perform a biopsy on the other head side.
Treatment
The primary treatment for people with this condition is high doses of corticosteroids (such as Prednisone). Physicians prescribe high doses of the medicine because it is necessary to prevent blindness. However, people begin to feel better within a few days of starting the treatment. For those who experience loss of vision before treatment usually, there is no chance to recover vision.
Treatment with corticosteroids usually lasts several years but after the first month, doctors often reduce the dose of the medication. Sometimes, certain symptoms may return during the period your doctor reduces the dose of the medication. Moreover, during this period a lot of people develop polymyalgia rheumatica symptoms. In such cases, doctors may prescribe additionally an immunosuppressant medicine (such as Methotrexate).
Unfortunately, corticosteroids can cause serious adverse reactions including hypertension (high blood pressure), osteoporosis (brittle bones), and muscle weakness. Thus, physicians recommend regular checkups and supplements to prevent the potential negative effects of corticosteroids.
Recently, the FDA (the U.S. Food and Drug Administration) has approved a medicine for giant cell arteritis treatment. It is called Tocilizumab and it is given as an injection under the skin. A common adverse effect of Tocilizumab injection is an increased risk of infections.
Home Remedies
The following tips should be used along with treatment and they can help overcome symptoms and adverse reactions caused by the medication. For example:
- Adopt a healthy diet – It is important to have a healthy diet because it prevents potential problems including hypertension, diabetes, and osteoporosis (bone loss). It is advised to include in your diet fresh vegetables and fruits, whole grains, and lean meats and fish. Limit or avoid salt, sugar, and alcohol. For people with giant cell arteritis is vital to get enough calcium and vitamin D. Healthcare providers recommend 1,200 milligrams (mg) of calcium and 800 international units (IU) of vitamin D daily.
- Regularly exercise – It is advised to regularly exercise, especially after a meal. Moreover, aerobic exercise (such as walking) also helps to prevent complications and adverse reactions to corticosteroids. Exercises also are beneficial for the lungs and heart and can improve your overall sense of well-being.
- Regular appointments with your doctors – To reduce the risk of adverse reactions it is advised to get checkups regularly.
- Aspirin – Consult with your doctor about administering between 75 and 150 mg of Aspirin daily because it may help to decrease the risk of stroke and vision loss.
Frequently Asked Questions
Is giant cell arteritis a serious health condition?
Yes, especially if it affects temporal arteries. Inflammation of the arteries on both sides of the head (temples) requires urgent treatment. Otherwise, it may lead to serious health problems including blindness.
What are the most common giant cell arteritis symptoms?
People with this condition usually experience the following symptoms. Check below some examples:
- Vision problems (such as double vision)
- Jaw pain
- Unexplained weight loss
- Fatigue (extreme tiredness)
- Fever
- Jaw pain, especially when chewing or opening the mouth wide
- Continuous severe head pain
- Scalp tenderness
If you experience any of the previous symptoms, immediately seek medical care or go to the nearest emergency room.
What are the possible complications of giant cell arteritis?
People with giant cell arteritis may experience the following complications, especially if they do not get treatment. For example:
- Aortic aneurysm and dissection
- Blindness
- Stroke
- Tongue necrosis
- Adverse reactions of Tocilizumab (such as infections, neutropenia, and others)
- Side effects of corticosteroids (including osteoporosis, cataracts, and others)
If you have additional questions, ask your physician.
