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Giant cell arteritis (say "ar-tuh-RY-tus"), or GCA, is inflammation of the blood vessels. It mostly affects the arteries that carry blood to the head, especially those that supply the eyes, temple, and jaw. Because it often affects the artery in the temple, it is also called temporal arteritis.
People who have giant cell arteritis need to be treated right away. That's because it can cause loss of vision and may lead to a stroke or mini-strokes.
Some people who have giant cell arteritis also have polymyalgia rheumatica. This is another inflammatory condition that affects the muscles. It causes pain and stiffness in the hip, neck, or shoulder area. The same medicines are used to treat both conditions.
Experts don't fully understand what causes it. It may be that the immune system is attacking the body's own tissues. Your genes may play a role in this. For example, people whose ancestors are from Scandinavia or Northern Europe are more likely to have this problem.
Giant cell arteritis occurs in women more often than men. It is more common as people get older.
Symptoms may start either suddenly or slowly. They may include:
Your doctor will do a physical exam and ask you about your symptoms and past health. For example, the doctor may look for arteries on the temple or forehead that are swollen, lumpy, or tender. This is a sign of giant cell arteritis.
The doctor will also consider your age in diagnosing this condition. People younger than 50 very rarely have giant cell arteritis.
The doctor may order tests too. These may include:
Some other conditions can cause similar symptoms. Your doctor may also do tests to rule out those conditions, which include arthritis and hypothyroidism.
Giant cell arteritis is treated with steroid medicines, which reduce inflammation. Giant cell arteritis is dangerous because it can cause serious problems, such as stroke or blindness. So your doctor may start you on the medicine right away, even before the diagnosis is confirmed.
You'll probably feel better in a day or two after you start the medicine. Most of the time, symptoms improve quickly and go away 2 to 4 weeks after treatment starts. But you may need to keep taking steroid medicine for 1 to 2 years or even longer. This helps to keep your symptoms from coming back.
Long-term treatment with steroid medicine will put you at risk for bone thinning (osteoporosis). This is because steroid medicines reduce how well your body takes in calcium, which is important in building strong bones. Your doctor may recommend a bone density test to see if you need to take a medicine to prevent osteoporosis. These medicines are called bisphosphonates. Or your doctor may simply start you on the medicine without the test.
Your doctor may also suggest that you take:
In some people, symptoms improve with treatment but then come back. This is called a relapse. It often occurs in the first 2 years of treatment or during the first year after steroid medicine is stopped. Your doctor will track your condition during this time. If you have a relapse, your doctor will increase the steroid dosage for a while. Then you can slowly lower it after your symptoms go away.
In rare cases, giant cell arteritis may affect the main part of the aorta, a large blood vessel in the chest. This can cause an aortic aneurysm, which can be life-threatening. Your doctor may want you to have chest X-ray each year to watch for this problem.
To protect your bones while you are being treated with steroid medicines:
Other Works Consulted
Both M, et al. (2006). Balloon angioplasty of arteries of the upper extremities in patients with extracranial giant-cell arteritis. Annals of the Rheumatic Diseases, 65(9): 1124–1130.
Hellmann DB (2013). Giant cell arteritis, polymyalgia rheumatica, and Takayasu's arteritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology, 9th ed., vol. 2, pp. 1461–1480. Philadelphia: Saunders.
Hellmann DB, Imboden JB Jr (2012). Musculoskeletal and immunologic disorders. In SJ McPhee, MA Papadakis, eds., 2012 Current Medical Diagnosis and Treatment, 51st ed., pp. 787–846. New York: McGraw-Hill.
Spiera RF (2016). Polymyalgia rheumatica and temporal arteritis. In L Goldman, A Shafer, eds., Goldman-Cecil Medicine, 24th ed., vol. 2, pp. 1801–1805. Philadelphia: Saunders.
Current as of: December 9, 2019
Author: Healthwise StaffMedical Review: Anne C. Poinier, MD - Internal MedicineMartin J. Gabica, MD - Family MedicineE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family Medicine
Current as of: December 9, 2019
Anne C. Poinier, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Kathleen Romito, MD - Family Medicine
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