Giant cell arteritis

Giant cell arteritis – also known as temporal arteritis – is a disease characterised by an inflammation of the lining of the arteries that can potentially lead to blindness, stroke or an aneurysm

An elderly couple with a doctor

Usually giant cell arteritis (GCA) adversely impacts the arteries in your head, particularly those in your temples, that is, your temporal arteries. It sees the lining of arteries becoming inflamed, which constricts your blood vessels and effectively decreases the amount of blood – thus starving your body of oxygen and vital nutrients – that your body’s tissues need to function properly. It can affect blood flow to your eyes, thus leading to loss of vision.  

It is not known why this condition inflames your arteries, although certain genes may increase the likelihood of you contracting the illness. Risk factors include:

  • A history of giant cell arteritis in your family
  • Most people first display symptoms above the age of 50
  • Caucasian women over the age of 50 have the highest risk of developing it
  • If you suffer from polymyalgia rheumatica (PMR), an inflammatory disorder that causes muscle pain and stiffness, you are at an increased risk. In fact, about half of all people who suffer from giant cell arteritis are also affected by polymyalgia rheumatica. 

If left untreated, it can lead to an aortic aneurysm (which may cause life-threatening internal bleeding), blindness, and even a stroke (although rarely).

What are its symptoms?

The symptoms of giant cell arteritis can include:

  • Flu-like symptoms
  • Fever 
  • Impaired vision, including temporary vision loss or double vision, or even sudden, permanent loss of vision in one eye
  • Jaw pain
  • Persistent headaches and tenderness that usually affects both temples
  • Scalp tenderness
  • Unexplained fatigue
  • Weight loss

How is it diagnosed? 

Your doctor will do a physical examination checking your signs and symptoms, and speak to you about your medical history. Giant cell arteritis is often difficult to diagnose, as its symptoms are similar to many other conditions. You may need to consult with a rheumatologist who is a specialist in inflammatory diseases of the blood vessels. 

There is no single test to diagnose the condition, so you will undergo tests that measure inflammation. Blood tests will be used such as the erythrocyte sedimentation rate that measures inflammation. 

A biopsy of your temporal artery – that is, a surgical removal of a small part of your artery with a local anaesthetic – is normally the most effective way to confirm the diagnosis of the condition. 

Imaging tests – including magnetic resonance angiography (MRA), a Doppler ultrasound and positron emission topography (PET) – may be used for a diagnosis and to monitor treatment progress. 

What are your treatment options? 

Your prognosis is usually very good if giant cell arteritis is diagnosed and treatment started early to ensure you do not suffer irreversible tissue damage. Early treatment usually ensures that you do not suffer serious complications such as permanent vision loss, stroke or aneurysm. 

Taking high doses of corticosteroid medications such as prednisone help prevent its symptoms, ensuring that you feel better within days of starting treatment. Your impaired vision should clear up within a few months, unless you have suffered complete vision loss. You will probably be on this medication for a year or two and then will be weaned off it slowly. 

Corticosteroids control inflammation. However, they can lead to serious side effects including high blood pressure (hypertension), muscle weakness and osteoporosis. To control your blood pressure, your doctor will probably recommend you overhaul your diet, start an exercise programme and take blood pressure medicine. Due to the potential adverse impact on your bone density, you may be prescribed prescription medicines and vitamins such as calcium and vitamin D

Relapses can occur and you could develop polymyalgia rheumatic, so you will need to keep a close eye on your health.

Can it be prevented?

To prevent relapses occurring, it is vital you take the following steps:

1. Follow a balanced diet to ensure you don’t develop osteoporosis, high blood pressure or diabetes. This includes supplementing with calcium and vitamin D. 

2. Pursuing regular aerobic exercise lowers your risk of bone loss, diabetes and high blood pressure (hypertension).

3. Ensure you go to your doctor regularly for check-ups to monitor any potential complications and side effects. 

4. You may be prescribed a daily low dose of aspirin to help decrease your risk for blindness and stroke. 

IMAGE CREDIT: 123rf.com

The accuracy of this information was checked and approved by physician Dr Thomas Blake in July 2016