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Giant cell arteritis -
(GCA)
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Diseases & Conditions
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Giant cell arteritis is a
condition which causes inflammation on the inside of some
arteries (blood vessels). It is called 'giant cell' because
typical large cells develop in the wall of the inflamed
arteries. The arteries commonly affected are those around
the head and neck area. The artery most commonly affected is
the temporal artery. (You have a temporal artery on each
side of the head. They are under the skin to the sides of
the forehead - the temples.) So, the condition is sometimes
called 'temporal arteritis'.
Giant cell arteritis (GCA) is an inflammation
of the lining of your arteries - the blood vessels that carry
oxygen-rich blood from your heart to the rest of your body. Although GCA
can affect the arteries in your neck, upper body and arms, it occurs
most often in the arteries in the head, especially the temples. For that
reason, the disorder is sometimes called temporal arteritis or cranial
arteritis. GCA is also known as granulomatous arteritis - a reference to
a particular type of inflammation
GCA frequently causes
headaches, jaw pain and
blurred or double vision. But the most serious
potential complications are blindness and, less
often, stroke. These problems can occur when
swelling in the arteries impairs blood flow to your
eyes or brain.
Although there's no cure for GCA, immediate
treatment with corticosteroid medications usually
relieves symptoms and prevents loss of vision.
Signs
and symptoms
The first case of GCA was described in 1890 by a British
surgeon whose patient complained that severe head pain prevented him
from wearing a hat. Times have changed, but the most common symptom of
GCA is still head pain and tenderness — often severe — that usually
occurs in both temples. Sometimes, however, you may have pain in only
one temple or in the front of your head.
Yet signs and symptoms of GCA can vary greatly. For some
people, the onset of the condition feels like the flu — with muscle
aches (myalgia), fever and fatigue, as well as headache.
Other common
signs and symptoms include:
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Decreased visual acuity or double vision.
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Scalp tenderness. It may hurt to comb your hair or even to lay your
head on a pillow, especially where the arteries are inflamed.
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Jaw
pain (jaw claudication) when you chew.
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Throat or tongue pain.
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Pain
and stiffness in your neck, arms or hips, which is usually worse in
the morning before you get out of bed. These are often symptoms of a
related disorder, polymyalgia rheumatica. Nearly half of all people
with GCA also have polymyalgia rheumatica.
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Sudden, permanent loss of vision in one eye.
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Weight loss.
If you develop any of these symptoms, see your doctor
without delay. Starting treatment as soon as possible can usually help
prevent blindness.
Related Sites:
Causes
Your arteries are pliable tubes with thick, elastic
walls. Oxygenated blood leaves your heart through your body's main
artery, the aorta. The aorta then subdivides into smaller arteries that
deliver blood to all parts of your body, including your brain and
internal organs.
In GCA, some of these arteries become inflamed, causing
them to swell. Although almost any large or medium-sized artery can be
affected, swelling most often occurs in the temporal arteries, which are
located just in front of your ears and continue up to your scalp. In
some cases, the swelling affects just part of an artery, with sections
of normal vessel in between.
Wherever it occurs, the swelling narrows the blood
vessels, reducing the amount of blood — and therefore oxygen and vital
nutrients — that reach your body's tissues. In some cases, a blood clot
may form in an affected artery, obstructing blood flow completely.
Diminished blood flow to your eyes can cause blindness, and an
interrupted blood supply to your brain can lead to a stroke.
Sometimes instead of becoming narrower, a blood vessel —
especially the aorta or one of its large branches — may weaken and form
a bulge (aneurysm), a potentially life-threatening condition.
Even without these serious complications, inflamed blood
vessels in your head frequently cause pain and tenderness, especially in
your temples.
What
causes GCA
Just what causes arteries to become inflamed in GCA isn't known. But
because the condition primarily affects people of Northern European
descent and tends to run in families, researchers believe that heredity
plays a role. And because GCA affects only people older than 50, aging
also appears to be a factor.
Some studies suggest a link between GCA and some types of
pneumonia and parvovirus infection, a mild disease that primarily
affects children. But other studies have failed to find such a link.
Risk
factors
Although the exact causes of GCA aren't known, several
factors can increase your risk, including:
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Age.
GCA affects older adults almost exclusively — the average age at
onset of the disease is 70, and it rarely occurs in people younger
than 50.
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Sex.
Women are two to three times more likely to develop GCA than men
are.
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Race.
Although GCA can affect people of any race, the vast majority are
white. People of Northern European origin are particularly at risk.
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Other health conditions.
Also at risk are people with rheumatoid arthritis and the arthritic
condition polymyalgia rheumatica (PMR), which causes stiffness and
aching in the neck, shoulders and hips. Fifteen percent to 25
percent of people with PMR also have GCA.
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