Summary about Disease
Giant cell arteritis (GCA) is an inflammatory disease that affects medium and large arteries, most commonly the arteries in the head, especially the temporal arteries. It can cause headaches, vision problems, jaw pain, and other symptoms. If left untreated, it can lead to blindness and other serious complications. GCA is most common in older adults, typically over the age of 50.
Symptoms
Severe headache (often a new type of headache)
Scalp tenderness (especially near the temples)
Jaw pain when chewing (jaw claudication)
Vision problems (double vision, blurred vision, temporary vision loss)
Fever
Fatigue
Weight loss
Muscle aches (polymyalgia rheumatica)
Tongue pain or soreness
Throat pain or hoarseness
Dry cough
Causes
The exact cause of giant cell arteritis is unknown. It's believed to be an autoimmune disorder, meaning the body's immune system mistakenly attacks its own arteries. Genetic factors and environmental triggers may play a role.
Medicine Used
Corticosteroids (e.g., Prednisone): These are the primary treatment to reduce inflammation quickly and prevent complications.
Tocilizumab (Actemra): A biologic drug (interleukin-6 receptor antagonist) that is used to help reduce the steroid dose and maintain remission.
Low-dose Aspirin: Often prescribed to help prevent stroke and other cardiovascular events.
Other immunosuppressants: Occasionally methotrexate or azathioprine may be used in addition to steroids.
Is Communicable
Giant cell arteritis is not communicable. It is not an infectious disease and cannot be spread from person to person.
Precautions
Early Diagnosis and Treatment: Seek medical attention promptly if you experience symptoms.
Medication Adherence: Follow your doctor's instructions carefully regarding medication dosage and schedule.
Regular Monitoring: Attend all scheduled follow-up appointments for monitoring of symptoms, side effects of medications, and disease activity.
Lifestyle Modifications: Adopt a healthy lifestyle including a balanced diet, regular exercise (as tolerated), and smoking cessation.
Protect Bone Health: Long-term steroid use can lead to bone loss. Discuss calcium and vitamin D supplementation with your doctor and consider bone density testing.
Manage Risk Factors: Work with your doctor to manage risk factors for cardiovascular disease, such as high blood pressure, high cholesterol, and diabetes.
Eye Exam: Schedule regular eye examinations.
How long does an outbreak last?
Without treatment, giant cell arteritis can persist for months or even years. With treatment, the initial inflammatory phase is typically controlled within weeks to months. However, treatment is often continued for a year or longer to prevent relapses. The total duration of treatment varies from person to person. Relapses can occur, requiring adjustments to medication.
How is it diagnosed?
Physical Examination: Doctor will assess your symptoms and perform a physical exam, paying particular attention to the temporal arteries.
Blood Tests: Elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are common.
Temporal Artery Biopsy: A small sample of the temporal artery is removed and examined under a microscope for signs of inflammation. This is the gold standard for diagnosis.
Imaging Studies: Ultrasound, MRI, or PET scans may be used to evaluate the arteries and look for signs of inflammation.
Timeline of Symptoms
The onset of symptoms can be gradual or sudden.
Initial Stage: Often starts with a persistent headache, scalp tenderness, and flu-like symptoms (fatigue, fever, weight loss).
Progression: Jaw pain during chewing may develop. Vision problems may occur, ranging from blurred vision to temporary or permanent vision loss.
Complications (if untreated): Without treatment, vision loss, stroke, or aortic aneurysm can occur. This timeline can vary significantly from person to person. Symptoms can fluctuate in intensity over time.
Important Considerations
Prompt treatment is crucial to prevent blindness and other serious complications.
Long-term steroid use can have significant side effects (weight gain, mood changes, osteoporosis, diabetes). Careful monitoring and management are necessary.
Tocilizumab can help reduce steroid dosage and associated side effects, but also carries its own risks.
Relapses can occur, even during treatment. Be vigilant and report any new or worsening symptoms to your doctor.
Patient education and support groups can be valuable resources.
Close communication with your doctor is essential for optimal management.