Giant Cell Arteritis
Giant cell arteritis (GCA) is a condition in which certain arteries
become inflamed. It is also called temporal arteritis, as it often affects the arteries
near the temples, although it can involve arteries in just about any part of the body. The
inflammation of the involved artery leads to narrowing and sometimes to complete blockage
of the blood vessel. This results in the surrounding tissues being deprived of an adequate
blood supply. When GCA involves the arteries that supply blood to the eyes, blindness in
one or both eyes may develop suddenly. Strokes may rarely occur. Some of the more common
symptoms in GCA include headaches, pain in the jaw or tongue muscles when eating or
talking, and tenderness of the scalp over the temples.
GCA and PMR seem to be related, as they often occur together. Over 10
percent of people with PMR also have GCA; approximately 50 percent of people with GCA also
have PMR.
Cause of Giant Cell Arteritis
The causes of PMR and GCA are not known. Because these are disorders
that occur primarily in older people, it has been suggested that these diseases may be
related somehow to the process of aging. A genetic predisposition seems to be involved.
Health impact of Giant
Cell Arteritis
- PMR and GCA almost always occur in people over the age of 50; the average
age of persons with these diseases is approximately 70.
- PMR and GCA occur twice as often in women as in men.
- Whites have a stronger predisposition to PMR and GCA.
- The prevalence of PMR is 700 per 100,000; that of GCA is 200 per 100,000.
Diagnosis of Giant Cell Arteritis
PMR is a syndrome, and unfortunately, there are no specific tests.
Other conditions that cause symptoms similar to PMR need to be excluded before the
diagnosis of PMR can be confidently made. The diagnosis of PMR is made based on the
history and physical examination along with blood tests. A biopsy of an affected blood
vessel – usually the temporal artery – is necessary to confirm GCA.
Treatment of Giant Cell Arteritis
The goal in treating PMR and GCA is to relieve the symptoms and, in the
case of GCA, to prevent damage to the tissues. The most commonly used medication is
prednisone. Usually patients with PMR respond very quickly to low doses; patients with GCA
usually require larger doses of this medication. Treatment often extends for two years or
longer. In mild cases of PMR, it may be possible to treat the symptoms with nonsteroidal
anti-inflammatory medications. Corticosteroids and nonsteroidal anti-inflammatory drugs
can have side effects which may be particularly severe in the elderly. Methotrexate may be
used as an alternative to steroids.
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