Giant Cell Arteritis

Giant cell arteritis (GCA) is a type of large vessel vasculitis, which is an inflammation of the blood vessels. It primarily affects the medium and large arteries, with a particular predilection for the branches of the external carotid artery, especially the temporal artery.

Causes and Risk Factors

The exact cause of giant cell arteritis is not fully understood, but it is believed to be an autoimmune disorder. It occurs when the immune system mistakenly attacks the blood vessels, leading to inflammation. The risk factors for developing GCA include:

• Age: Typically affects people over the age of 50 years
• Sex: More common in women than men
• Genetics: Family history may play a role

Symptoms

The symptoms of giant cell arteritis can vary, but they often include:

• Headaches: Often severe and localized to one side of the head
• Jaw claudication: Pain in the jaw when chewing or talking
• Visual disturbances: Blurred vision, double vision, or loss of vision in one eye
• Scalp tenderness: Pain and sensitivity on the scalp
• Fever: Low-grade fever may be present
• Malaise: Feeling unwell or tired
• Muscle aches: Pain and stiffness in the muscles, especially in the shoulders and hips

Diagnosis

The diagnosis of giant cell arteritis is based on a combination of clinical evaluation, laboratory tests, and imaging studies. The diagnostic criteria include:

• Age: Typically over 50 years old
• Elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP): Indicative of inflammation
• Temporal artery biopsy: Shows giant cells and inflammation in the blood vessel wall
• Imaging studies: Such as ultrasound, magnetic resonance angiography (MRA), or positron emission tomography (PET) scans to visualize the affected blood vessels

Treatment

The treatment of giant cell arteritis typically involves:

• Corticosteroids: High-dose prednisone is often prescribed to reduce inflammation and prevent complications
• Immunosuppressive medications: May be used in conjunction with corticosteroids or as an alternative for patients who cannot tolerate steroids
• Aspirin: Low-dose aspirin may be recommended to reduce the risk of visual loss and other complications

Complications

If left untreated, giant cell arteritis can lead to serious complications, including:

• Visual loss: Permanent blindness in one or both eyes
• Aortic aneurysm: Inflammation of the aorta can lead to weakening and rupture of the blood vessel wall
• Stroke: Reduced blood flow to the brain can cause a stroke

Prognosis

The prognosis for giant cell arteritis is generally good with prompt treatment. However, some patients may experience relapses or persistent inflammation, requiring ongoing management and monitoring.