Giant Cell Arteritis: Symptoms, Diagnosis, Treatment

Overview

Giant cell arteritis (GCA) is a chronic inflammatory disorder affecting the blood vessels by blocking the blood flow. It may occur accompanying a polymyalgia rheumatica, another inflammatory disease that causes pain and stiffness, mostly in the shoulders.

GCA will lead to swelling and thickening of temporal artery, so it is also known as temporal arteritis.

The common symptom of GCA is a new and persisting headache. When GCA blocks the blood flow to the eye, vision loss would occur.

GCA mainly occurs in women over 50 years old, most commonly between the ages of 70 and 80 years. Although women are more likely to develop GCA than men, studies indicate that men are more likely to suffer vision loss.


Causes

The exact cause of GCA is unknown. The underlying mechanism is that the body’s immune system considers normal blood vessels as invaders and attack them, causing inflammation and swelling in these blood vessels. Arteries around the head and neck are most likely to be attacked.

Risk factors of this disease include:

  • Age.

It is rare for people under 50 years old to develop GCA.

  • Sex.

Women are about two times more likely to get affected than men.

  • Race and geographic region.

White people in Northern European populations or with Scandinavian ancestry are more common to have this disease.

  • Health condition.

People with polymyalgia rheumatica are at a higher risk of developing GCA.

  • Genetic factor.

Occasionally, GCA may run in families.


Symptoms

Early symptoms of GCA resemble those of flu, such as fatigue, fever and loss of appetite.

Other signs and symptoms associated with GCA are:

  • Severe and persistent headache
  • Tenderness of the scalp
  • Weight loss
  • Potential loss of vision or double vision
  • Dizziness
  • Jaw and tongue pain when eating or talking
  • Chest pain
  • Sore throat


Diagnosis

The diagnosis of GCA is largely based on the appearing symptoms and a physical examination. Doctors would examine if your temporal artery is inflamed and tender to the touch. Your decreased pulse may be another sign of GCA.

Some blood tests can help diagnosis GCA and trace your progress during treatment. Two common blood tests are:

This test measures how quickly your red blood cells (erythrocytes) fall to the bottom of a tube of blood within an hour. The normal rate of the sedimentation is 1–40 mm/hour. A drop rate of over 60 mm/hour indicates that you have an inflammation in the body.

This is to check a substance produced by your liver when an inflammation occurs.

The best method to diagnose GCA is biopsy. Doctors will take a small sample of the temporal artery and then examine it under a microscope to see if there are signs of inflammation. If the first biopsy cannot confirm the diagnosis, doctors would do a biopsy of the temporal artery on the other side of your head.

Besides, some imaging tests can also help with the diagnosis of GCA, like doppler ultrasound, magnetic resonance angiography (MRA) combining with MRI and positron emission tomography (PET).


Treatment

The most useful treatment option for GCA is high doses of prednisone (a type of corticosteroids). Since immediate treatment is important to prevent blindness caused by GCA, your doctor may prescribe medication for you even before confirming the diagnosis. After taking the high-dose corticosteroid for one month, your doctor would gradually decrease the dosage.

You may continue to take medication for one or two years or even longer to protect you from future attacks. However, corticosteroids can result in serious side effects, such as high blood pressure and muscle weakness. So, watch up the symptoms and follow your doctor’s advice closely when taking this medication

In May 2017, the Food and Drug Administration approved tocilizumab (Actemra) to treat GCA. It’s given as an injection under your skin.


Keywords: giant cell arteritis; GCA.


Related Posts:

Corticosteroid: Use and Side Effects

Prednisone – Uses & Side Effects

Tocilizumab (Actemra): Uses, Side Effects

Erythrocyte Sedimentation Rate (ESR) – Reference Range

C-Reactive Protein Test – Normal Range

What’s a Frontal Lobe Headache?

* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.