Giant Cell Arteritis

1 What is Giant Cell Arteritis?

Giant cell arteritis is a condition characterized by inflammation of arteries, particularly of neck, head, and arms. It most commonly affects the arteries of the temple region and hence is known as temporal arteritis. 

It causes pain and soreness in and around temples, and pain in the jaws while eating. Giant cell arteritis may also lead to vision loss. It is more prevalent among people who are above 50 years, and women are more likely to develop inflammation when compared to men. 

The exact cause of the condition is not known. Certain medications and severe infections are associated with giant cell arteritis. 

Temporal arteritis may lead to several complications, but early detection and treatment reduce the chances of complications.

2 Symptoms

Headache and tenderness are the two most common symptoms of giant cell arteritis. It affects both the sides of the temple and often starts as a normal flu-like condition. 

Headache may develop all on a sudden or gradually over days or weeks, and may be one-sided or two-sided. General symptoms of this condition include:

  • Pain in the jaws while chewing or talking
  • Tenderness in the scalp
  • Severe headache, particularly in the temples
  • Fatigue
  • Fever
  • Unexplained weight loss
  • Vision loss or double vision
  • Sudden permanent loss of vision in one of the eyes

About 50% of the patients with giant cell arteritis have a related condition called polymyalgia rheumatica

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3 Causes

Inflammation of the lining of the large and medium-sized arteries is the is the main cause of giant cell arteritis. 

Swelling of the blood vessels narrows the arteries and reduces the blood flow through them. It is most commonly seen in the blood vessels of the temples. 

The actual cause of inflammation of arteries is not known. Certain genes and genetic changes are implied as risk factors of the condition. It is seen to affect adults only, particularly those who are above 50 years. 

The risk of giant cell arteritis is two times more in women when compared to men. Presence of polymyalgia rheumatica increases the risk of giant cell arteritis. The condition is found to run in families.

4 Making a Diagnosis

Early stages of giant cell arteritis have generalized symptoms, making diagnosis difficulty. Physical examination of the temporal arteries reveals tender arteries with reduced pulse. 

They usually have hard, cord-like feel. Blood test is used to measure the erythrocyte sedimentation rate (ESR), the measure of inflammation. Measuring C-reactive protein also indicates inflammation. 

Biopsy of the temporal artery is used to check for inflammation and structural changes like abnormally large cells. Imaging techniques are also used to diagnose temporal arteritis. 

Magnetic resonance angiography injects a contrast dye into the blood vessel and helps in visualizing the soft tissues. Blood flow through the blood vessels is evaluated using Doppler ultrasound

PET uses a radioactive dye which when injected into the blood vessel helps in producing detailed images of the arteries and veins.

5 Treatment

Corticosteroid injections are commonly used in the treatment of giant cell arteritis. Visual symptoms usually resolves within few weeks of corticosteroid treatment. 

The dosage is gradually reduced until the lowest dose and the medication is continued for years. Methotrexate is used to reduce the side effects of corticosteroid injections.

6 Prevention

There is no standard preventive measure for giant cell arteritis.

Early detection and treatment of the condition helps in preventing complications.

7 Alternative and Homeopathic Remedies

A few alternative remedies exist for giant cell arteritis.

Aerobic exercises are suggested to relieve symptoms of this condition. Whole licorice and anti-inflammatory medications are also tried as alternative treatment methods for temporal arteritis. 

Techniques such as hypnotherapy and guided imagery may also be of help in reducing the symptoms. Donglingcao Pian is a Chinese herbal remedy implied in the treatment of giant cell arteritis.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with giant cell arteritis.

Coping with the side effects is a challenge in corticosteroid treatments. Eating a healthy diet with plenty of fresh fruits and vegetables, calcium, and vitamin D helps to prevent problems like thinning of bones and hypertension

Regular exercise is also helpful in reducing bone loss and improves overall health. Regular checkups are important to monitor health and to prevent complications. 

Understand about the condition more to feel more confident about the treatment methods and side effects. Being a part of the support group also help in coping with the condition.

9 Risks and Complications

There are several complications associated with giant cell arteritis.

Giant cell arteritis result in reduced blood flow to the eyes leading to sudden, painful vision loss in one or both eyes. 

It also increases the chances of aortic aneurysms which is associated with a number of complications including rupture of blood vessel leading to hemorrhage. 

Stroke is another rare complication associated with temporal arteritis.

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