Summary about Disease
Temporal arteritis, also known as giant cell arteritis (GCA), is an inflammatory disease that affects the medium and large arteries of the body. It most commonly affects the arteries in the temples (hence the name "temporal" arteritis), but it can also involve other arteries, including those in the head, neck, and arms. The inflammation can cause the arteries to narrow or become blocked, disrupting blood flow. This can lead to a variety of symptoms, including headaches, jaw pain, vision problems, and fatigue. Left untreated, it can lead to serious complications like blindness.
Symptoms
Headache: Often severe, persistent, and localized in the temples.
Jaw pain: Pain when chewing, known as jaw claudication.
Vision problems: Double vision, blurred vision, or sudden vision loss.
Scalp tenderness: Pain when touching the scalp, especially near the temples.
Fatigue: Feeling unusually tired.
Fever: Low-grade fever may be present.
Muscle aches: Aches and stiffness, especially in the neck, shoulders, and hips (symptoms of polymyalgia rheumatica, which often occurs with temporal arteritis).
Tenderness or throbbing in the temples.
Unintentional weight loss.
Sore throat.
Cough.
Causes
The exact cause of temporal arteritis is unknown. It is thought to be an autoimmune disorder, where the body's immune system mistakenly attacks healthy arteries. Genetic and environmental factors may also play a role. It's more common in older adults, particularly those over 50.
Medicine Used
Corticosteroids (e.g., Prednisone): These are the primary treatment for temporal arteritis. High doses are usually prescribed initially to quickly reduce inflammation.
Tocilizumab (Actemra): A biologic drug that can be used in conjunction with corticosteroids or as a steroid-sparing agent for long term managment.
Low-dose Aspirin: Sometimes prescribed to help prevent blood clots.
Calcium and Vitamin D supplements: Prescribed to combat the bone thinning side effects of long term corticosteroid use.
Is Communicable
No, temporal arteritis is not communicable. It is not an infection and cannot be spread from person to person.
Precautions
Early diagnosis and treatment: Prompt treatment is essential to prevent serious complications like vision loss. See a doctor immediately if you suspect you have temporal arteritis.
Follow your doctor's instructions carefully: Adhere to the prescribed medication regimen and attend all follow-up appointments.
Monitor for side effects of medication: Corticosteroids can have significant side effects, so be aware of potential problems and discuss them with your doctor.
Protect your bones: Since long-term steroid use can weaken bones, take calcium and vitamin D supplements and consider bone density testing.
Manage other health conditions: People with temporal arteritis may also have other health conditions, such as high blood pressure or diabetes, that need to be managed.
Eye exams: Regular eye exams are crucial, especially during treatment and follow-up, to monitor for vision changes or complications.
How long does an outbreak last?
Without treatment, temporal arteritis can last for months or even years. With corticosteroid treatment, symptoms usually improve within a few days to weeks. However, treatment is typically long-term, often lasting for one to two years or longer, with gradual tapering of the medication as symptoms improve and inflammation markers normalize. Relapses can occur, requiring adjustments to the treatment plan.
How is it diagnosed?
Physical examination: The doctor will perform a physical exam and ask about your symptoms.
Blood tests:
Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP): These tests measure inflammation in the body and are usually elevated in people with temporal arteritis.
Complete blood count (CBC): This test can help rule out other conditions.
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 tests:
Ultrasound: Can assess the temporal artery.
Magnetic resonance angiography (MRA) or computed tomography angiography (CTA): Can visualize the arteries and identify areas of inflammation.
PET Scan: Can identify areas of inflammation in blood vessels.
Timeline of Symptoms
The onset of symptoms can vary from person to person. Some people experience a sudden onset of severe symptoms, while others have a more gradual development of symptoms over days or weeks.
Early symptoms: Headache, fatigue, muscle aches, and fever may be the initial symptoms.
Later symptoms: Jaw pain, vision problems, and scalp tenderness may develop as the inflammation progresses.
Without treatment: Symptoms can worsen over time, potentially leading to vision loss or other serious complications.
Important Considerations
Risk of blindness: Vision loss is a serious complication of temporal arteritis, emphasizing the importance of early diagnosis and treatment.
Polymyalgia rheumatica (PMR): Temporal arteritis often occurs with PMR, so it's important to be aware of the symptoms of PMR (muscle aches and stiffness in the neck, shoulders, and hips).
Side effects of treatment: Corticosteroids can have significant side effects, such as weight gain, mood changes, increased risk of infection, and bone loss.
Relapses: Temporal arteritis can relapse, even after successful treatment, so it's important to continue monitoring for symptoms and follow up with your doctor.
Individualized treatment: The treatment plan should be individualized based on the severity of the disease, the presence of other health conditions, and the patient's response to medication.
Long-term follow-up: Regular follow-up appointments are necessary to monitor for relapses, adjust medication dosages, and manage any complications.