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Clinical Services at Rush Types of Vasculitis

Giant cell arteritis (GCA)

What causes giant cell arteritis?
What are the symptoms of giant cell arteritis?
How is the diagnosis of giant cell arteritis made?
What is the treatment for giant cell arteritis?
What is the prognosis for giant cell arteritis?

Giant cell arteritis (GCA) is a large vessel vasculitis that affects the aorta (the largest artery in the body) and its major branches. It is sometimes called temporal arteritis or Horton’s disease. GCA affects mostly patients older than 50 years of age and may accompany another condition called polymyalgia rheumatica (an illness that causes aches and stiffness in the neck, shoulders and hip girdles with evidence of inflammation in the blood).

What causes giant cell arteritis?

The cause of GCA remains unknown. It is considered an autoimmune disease, whereby the immune system becomes overstimulated and attacks the large vessels of the body. Many research studies have raised the possibility of an infectious agent like viruses and bacteria. However, a true correlation between infections and GCA has not yet been established.

What are the symptoms of giant cell arteritis?

As mentioned previously, GCA causes inflammation of the aorta and its major branches. When arteries are inflamed, they may either dilate or collapse and block the blood supply to vital organs. One of the most frequently affected arteries in GCA is the temporal artery. (If you put your index finger between your eye and ear, you may feel the pulse of the temporal artery.)

GCA causes:

  • Severe, persistent headaches
  • Jaw fatigue while chewing
  • Scalp tenderness
  • Blurry, double or decreased vision
  • Fever
  • Loss of appetite
  • Fatigue
  • Weight loss
  • Muscle aches
  • General ill feeling
  • Excessive sweating

How is the diagnosis of giant cell arteritis made?

  • Biopsy of temporal artery
  • Erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • Chest X-ray or CT/MR angiogram

What is the treatment for giant cell arteritis?

The best treatment we have to date is corticosteroids like prednisone. High doses of prednisone are initially required to control the inflammation. Later, the dose is slowly tapered over 12 to 18 months based on clinical response and blood work. A low-dose aspirin (baby aspirin) is usually added to prednisone to prevent heart attacks and strokes. There are no other treatments to date that have been clearly proven to treat GCA. Research studies are being conducted to discover novel therapies for GCA.

What is the prognosis for giant cell arteritis?

The prognosis is generally good. However, if untreated, GCA may lead to organ damage like loss of vision, strokes, stenosis (blockage of the vessels) and aneurysms (dilatation of the vessels). The main goal of the treatment is to prevent organ damage. In addition, we recommend yearly chest X-rays or CT angiograms to rule out involvement of the aorta or other large vessels. We also get a baseline bone density analysis to rule out osteoporosis (bone fragility), because giving prednisone for a long period of time increases the risk of osteoporosis.
 





Contact Name
Rush Vasculitis Clinic
Contact Phone
(312) 563-2800
Contact E-mail
contact_rush@rush.edu



Location
Orthopedic Building
1611 W. Harrison St., Suite 510
Chicago, IL 60612



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