Our blood vessels are a vital part of the cardiovascular system; they carry blood, nutrients, and oxygen around the body. However, they can also succumb to diseases such as giant cell arteritis, in which the blood vessels—generally those in the head and temporal region—become inflamed. The condition is also called temporal arteritis. It is possible to reduce the risk of complications such as vision loss with prompt medical treatment.
Giant cell arteritis affects the blood vessels. More specifically, it causes inflammation in the lining of the arteries. As the disease progresses, the vessels narrow, which ultimately disrupts blood flow. Experts often link this condition to polymyalgia rheumatica, an inflammatory disorder that generally affects the older population.
Giant cell arteritis is most common among women over the age of 50. While not as prevalent in the male population, they too can develop the inflammatory disease—especially if they are between the ages of 70 and 80. Risk of the disease continues to increase with age.
The exact cause of giant cell arteritis is unknown. However, many researchers believe it is an autoimmune condition in which the body’s immune system attacks the arteries. Considering it is rare among young adults, aging likely plays a role in the disease's development. Like most disorders, genetic and environmental factors are likely involved, as well.
In the early stages, giant cell arteritis may resemble the flu, in that individuals will experience fever, fatigue, and loss of appetite. As the blood vessels in the head become inflamed, symptoms can progress to include severe headaches, tenderness of the temples or scalp, double vision, temporary vision loss, jaw pain, sore throat, difficulty swallowing, chest pain, and dizziness.
Anyone who experiences the aforementioned symptoms for any extended period of time should speak to a doctor. People already diagnosed with giant cell arteritis require prompt treatment with oral corticosteroids -- this is crucial in preventing complications such as blindness. Most doctors also recommend regular follow-ups.
In most cases, doctors diagnose giant cell arteritis based on symptoms and a physical examination. There is no simple blood test to confirm the diagnosis. Instead, physicians may order a temporal artery biopsy, which requires removing a small piece of the artery to examine under the microscope. Depending on the patient, more than one biopsy may be necessary. At their discretion, they may also order an ultrasound of the temporal arteries.
Giant cell arteritis can lead to blindness if not properly treated because the disease can restrict blood flow to the eyes. While it can occur in one or both eyes, the loss of vision is typically permanent. Patients with this inflammatory disease also have an increased risk of suffering an aortic aneurysm, a bulge that forms in weakened blood vessels that can cause life-threatening internal bleeding if it bursts. Considering the potential complications, it is important to monitor the condition with annual imaging tests such as CT scans or ultrasounds.
High doses of corticosteroids can effectively treat giant cell arteritis. Fortunately, the symptoms tend to disappear quickly with proper treatment; to keep the disease from recurring, however, individuals often must continue the therapy for a few years. Immunosuppressants are also an option for some patients.
Many people experience side effects from taking high doses of corticosteroids. It is not uncommon for the medication to cause bone loss in some individuals. To prevent fractures, these people should also take vitamin D and calcium supplements and undergo regular bone density tests. Other common side effects associated with high doses of corticosteroids include weight gain, jitters, and insomnia. Fortunately, these complications are reversible and generally improve as dosages are scaled down.
Giant cell arteritis often coexists with polymyalgia rheumatica, another inflammatory disorder that causes pain and stiffness in the body. Some speculate the two are different manifestations of the same disease. According to a recent study published in Neurology, the varicella-zoster virus may also play a role in triggering this inflammatory response.
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