Giant Cell Arteritis

Giant cell arteritis is one form of vasculitis, a group of diseases that cause inflammation of blood vessels, especially arteries. In giant cell arteritis, this inflammation most commonly affects the arteries of the scalp and head – particularly over the temples – which is why the condition also is called temporal arteritis.

Symptoms of Giant Cell Arteritis

Symptoms of giant cell arteritis include:

  • a new headache, especially in the area of the temples, or anywhere on the head including the top, front, and back of the skull
  • unusual fatigue
  • poor appetite
  • weight loss
  • flu-like feelings
  • fevers
  • pain in the jaw, tongue, or throat

If giant cell arteritis progresses to the blood supply of the eyes, vision can be lost. For this reason it is important that the disease be diagnosed and treated as soon as possible. Symptoms of eye involvement include:

  • temporary blurring of one eye
  • double vision
  • blindness, which can occur suddenly and cannot be reversed

Risk Factors for Giant Cell Arteritis

While the cause of giant cell arteritis is not known, the disease affects:

  • only adults over the age of 50 (and most commonly over the age of 60)
  • women more than men
  • whites more than non-whites

Also, giant cell arteritis can occur with another disease that affects older adults called polymyalgia rheumatica.

Diagnosis of Giant Cell Arteritis

Tests for inflammation, such as the sedimentation rate or C-reactive protein, are usually high in people who have giant cell arteritis. But other diseases can cause elevations of these tests, so in order to prove the diagnosis of giant cell arteritis, it is usually necessary to biopsy a small section of the temporal artery for microscopic examination. This procedure is brief, done under local anesthesia in the outpatient setting, and leaves no noticeable scar.

Treatment of Giant Cell arteritis

It is essential that treatment for giant cell arteritis begin as soon as possible because of the risk of vision loss. If there is a high suspicion that giant cell arteritis is present, treatment may be started while the results of biopsy are awaited.

Treatment requires daily corticosteroids, such as prednisone, initially given in high doses. Headache and other symptoms rapidly improve, and the risk of loss of vision is prevented. After one month, a gradual taper of corticosteroids is begun; by six months, the prednisone dose is usually down to 5-10 mg per day, and, in most patients, can be entirely stopped by a year.

The Fast Track Clinic for Giant Cell Arteritis at Brigham and Women’s Hospital (BWH) offers rapid evaluation for patients with suspected giant cell arteritis. We provide patients with evaluation by a rheumatologist on our team within one business day of referral.

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