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by Hollenstein J
(GCA; Temporal Arteritis)

Definition

Giant cell arteritis (GCA) is inflammation of the arteries. The most common are the small and medium sized arteries in the head.

Temporal arteritis is a form of GCA. The temporal artery runs over the temple to the outside of the eye. This needs care right away to prevent vision loss or a stroke .

Temporal Arteritis
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Causes

The exact cause of GCA is unknown. The immune system attacks healthy arteries. This causes inflammation. It’s not known what causes the immune system to be overactive.

Risk Factors

GCA is more common in women. The chances are higher for people:

  • Aged 50 years and older
  • With a family history
  • Of Scandinavian or northern European descent
  • Who have polymyalgia rheumatica —causes stiffness and pain the neck, shoulder, or hip muscles

Symptoms

GCA may cause:

  • Fever
  • Tiredness
  • Loss of hunger
  • Weight loss
  • Night sweats
  • Joint or muscle aches

Temporal arteritis may cause:

  • Headaches
  • Scalp pain or tenderness over the artery
  • Jaw or tongue pain
  • Pain when chewing

Vision problems:

  • Partial or complete vision loss
  • Effect like a window shade closing over your eyes
  • Double vision

Diagnosis

The doctor will ask about your symptoms and health history. You may have:

  • A physical exam
  • An eye exam
  • Blood tests
  • Biopsy of the temporal artery
  • Ultrasound

Treatment

Care will start as soon as GCA is suspected. It may involve:

  • Corticosteroids—To lower inflammation. Doses start high, then are lowered over time.
  • Medicines to change how the immune system works.
  • Low-dose aspirin—To lower the chances of vision loss. This may not be helpful for everyone. Don’t start taking it until you talk to your doctor.

Prevention

There is no way to prevent GCA since the cause is unknown.

RESOURCES

Arthritis Foundation  https://www.arthritis.org 

National Institute of Neurological Disorders and Stroke  https://www.ninds.nih.gov 

CANADIAN RESOURCES

Health Canada  https://www.canada.ca 

College of Family Physicians of Canada  http://www.cfpc.ca 

References

Giant cell arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Available at: https://www.niams.nih.gov/health-topics/giant-cell-arteritis. Updated May 30, 2016. Accessed July 10, 2018.

Giant cell arteritis and polymyalgia rheumatica. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/giant-cell-arteritis-and-polymyalgia-rheumatica. Updated March 12, 2018. Accessed July 10, 2018.

Giant cell arteritis (including temporal arteritis). EBSCO DynaMed Plus website. Available at:  https://www.dynamed.com/topics/dmp~AN~T115154/Giant-cell-arteritis-including-temporal-arteritis  . Updated April 23, 2018. Accessed July 10, 2018.

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