What is Giant Cell Arteritis?

Giant cell arteritis is a type of disease-causing inflammation in major blood vessels of the arm, neck, and scalp. The disease is caused by an accumulation of abnormal giant cells and a grain substance in the artery.

Giant cell arteritis

Giant cell arteritis, also called temporal arteritis, is a type of disease-causing inflammation in major blood vessels of the arm, neck, and scalp. The disease is caused by an accumulation of abnormal giant cells and a grain substance in the artery. The inflammation either hinders or completely blocks the blood vessels that disrupts the normal circulation of blood.

Giant Cell Arteritis

The pain caused by Giant Cell Arteritis is usually concentrated in the temple area. In case of complete blockage, the person may experience sudden vision loss to one or both eyes. Blindness may be temporary and will depend on the severity of the blockage but it usually leads to permanent vision loss. About two persons in a thousand may experience this condition.  Women are more at risk than men and cases appears to be particularly common to the Caucasian race in Europe over seventy years old. Symptoms may include muscle pains in any area of the head, headaches, stiffed neck, and high fevers.

Studies are still being conducted to the present regarding the causes of giant cell arteritis. Researchers say that it involves the immune system attacking artery walls in the head area, but the reason why it attacks is unknown. Environmental and hereditary factors may also play a role in the development of giant cell arteritis. Giant cell arteritis was first described in the 1890s.

Giant cell arteritis is also linked to another inflammatory disease called polymyalgia rheumatica and it may develop before or after giant cell arteritis. Though the association between the two disorders is unclear; studies observed that forty percent of individuals with a history of giant cell arteritis also developed polymyalgia rheumatica.

The individual will need immediate medical attention as soon as signs and symptoms start to appear. There’s no cure for this condition but through proper treatment, life expectancy is generally normal.

Causes

Experts are still unclear on what causes this condition; but they have associated the development of giant cell arteritis to genetics, antibiotic overdosage, and history of cardiovascular disease. What is clear is that there are signs of unusual immune system behavior, where it attacks the healthy arteries. The reason for this unusual behavior is yet to be identified by researchers.

Genes and environment are potential factors in triggering and developing giant cells arteritis. We might have inherited the faulty gene from our parents and may not know that we carry the genes until certain environmental conditions triggered the development of this disease.

Giant cell arteritis inflames the artery walls located in the temple area, causing swelling and enlargement of the arteries. The inflammation affects normal blood flow that may eventually lead to permanent vision loss if not given proper medical attention.

Individuals at Risk

In the United States, approximately 100,000 people are affected by giant cell arteritis.

Groups classified below showed a higher rate of developing giant cell arteritis:

  • Hereditary – As mentioned, the individual has a higher risk of developing this condition if the person has a family history of giant cell arteritis. It can later progress in life if certain conditions activated it.
  • Age – It is common to people over age 70, but it may occur at an earlier age over 50 years old. It rarely affects individuals under the age of 50.
  • Ethnic group – Researchers observed that giant cell arteritis usually occurs to Caucasian individuals with Scandinavian or European descent.
  • Gender – this condition is likely to occur to women than men.
  • Polymyalgia rheumatica – with or without a history of polymyalgia rheumatica, an individual may have giant cell arteritis. But research shows that persons who have polymyalgia rheumatica have higher risks of developing giant cell arteritis later in life.

Symptoms

The main characteristic symptom of giant cell arteritis is headache that is concentrated in the temporal region of the head. This is because the disease targets blood vessels in those areas causing inflammation and blockage that may eventually lead to permanent blindness.

This condition primarily targets the arteries located in the regions of the head. However, in some cases, the inflammation may occur in any part of the body so symptoms may differ depending on which artery or blood vessel is affected. Symptoms may progressively develop and may have episodes of a sudden burst of pain.

Listed below are signs and symptoms of giant cell arteritis:

  • High fever
  • Unusual feeling of tiredness
  • Sudden weight loss
  • Frequent headaches occurring over the forehead. Pain progressively worsens and experiencing headache episodes where a sudden burst of pain comes back and forth occurs. At the same time, the individual may notice tenderness in the scalp.
  • Jaw pains especially when chewing.
  • Partial or total vision loss that may happen on one eye or both. Vision impairment may occur unexpectedly and with no pain.
  • Respiratory problems may occur, for example, dry cough.
  • Joint pains and swelling in joint areas like the hands, feet, and knees.
  • In rare events, it may lead to stroke, dementia, or any type of central nervous system complications.
  • Pain in the neck, hip, or shoulders that may also be associated with polymyalgia rheumatica.

Diagnosis

Detecting giant cell arteritis could be challenging because of its similarities with other symptoms, particularly polymyalgia rheumatica.

To conclusively diagnose if its giant cell arteritis, aside from symptoms and medical background; your doctor may conduct a physical examination and closely observe the temporal arteries.

Your doctor may also order the following tests:

  • Blood testing – This test measures red blood cells and a kind of substance the liver produces when the body is experiencing inflammations.
  • Biopsy – A tiny tissue sample of the artery will be taken from the patient. Usually, local anesthetics are used to perform this procedure. The sample will be observed in the laboratory to look for any signs of inflammation and giant cells. If results were unclear, your doctor may order another test.
  • Brains scans – Your doctor will look for signs of inflammation through imaging test.  Image tests may include positron emission tomography (PET), magnetic resonance angiography (MRA), or Doppler ultrasound.

Treatment

Your doctor may prescribe a drug called prednisone, which has a high dosage of corticosteroid.

Within a few days, there should be improvements. Vision loss might be prevented but if the patient has started taking corticosteroid with vision impairment already occurred, it may not improve his conditions.

Length of medication intake will depend on the doctor’s judgment but usually, it lasts for two years. Within a month of intake, your doctor will evaluate your condition and start lowering your dosage of corticosteroids until the lowest level of dosage is reached to manage the inflammation.

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