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Giant cell arteritis

by Jenna Hollenstein, MS, RD

Definition

Temporal arteritis is a condition of inflammation of the arteries. It affects the head, neck, upper body, and arms. The temporal artery is most often affected. It runs over the temple, to the outside of the eye. In extreme or untreated cases, this condition can lead to blindness or strokes. Two other terms often associated with this condition include:

  • Giant cell arteritis (GCA)—another name for temporal arteritis
  • Vasculitis—a general term for swelling or inflammation of blood vessels
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© 2009 Nucleus Medical Media, Inc.

Causes

The cause of temporal arteritis is not known. It may result from an immune response in the body.

Risks

Factors that increase your risk of temporal arteritis include:

  • Age: 50 or older
  • Race: White, especially of Scandinavian or northern European descent
  • Location: northern latitudes
  • Sex: female
  • Family member with temporal arteritis
  • Polymyalgia rheumatica , a condition characterized by stiffness and pain in muscles of the neck, shoulders, lower back, hips, and thighs
  • Smoking and low body weight

Symptoms

Symptoms may include:

  • Headaches that are usually localized and one-sided
  • Fever or flu -like symptoms
  • Pain when chewing
  • Pain in the jaw or tongue
  • Scalp pain or tenderness over the temporal artery
  • Anemia
  • Fatigue
  • Loss of appetite and weight loss
  • Vision loss
  • Sweats
  • Aches in the joints or muscles

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Diagnosis is based on the occurrence of certain factors, including:

  • Age: 50 or older
  • New localized headache
  • Temporal artery tenderness or decreased temporal artery pulse
  • Sedimentation rate of 50 mm/hour or greater
  • Abnormal temporal artery biopsy
  • Anemia

Tests may include:

  • Blood tests, including a sedimentation rate, c-reactive protein, hemoglobin, or hematocrit
  • Biopsy —removal of a sample of the temporal artery for testing
  • Retinal exam
  • Ultrasound of the temporal artery

Treatment

Treatment may include:

This therapy is used to decrease the swelling and inflammation. It will also help decrease the risk of blindness. At first, high doses of prednisone are often given. The doses are then tapered off. Therapy is often continued for several years.

Long-term use of corticosteroids has some harmful side effects. This may include:

  • Osteoporosis —weakening of bones
  • Diabetes —high glucose levels in blood
  • Cataracts —clouding of the eye's lens
  • Stomach irritation
Supplements will help to stop these effects on the bone. The supplements may include:
  • Calcium
  • Vitamin D
  • Bisphosphonate

Prevention

There is no known way to prevent temporal arteritis.

Last reviewed September 2009 by David N. Smith, MD

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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