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Giant Cell Arthritis
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Giant cell arteritis - (GCA)

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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:

  • Decreased visual acuity or double vision.

  • Scalp tenderness. It may hurt to comb your hair or even to lay your head on a pillow, especially where the arteries are inflamed.

  • Jaw pain (jaw claudication) when you chew.

  • Throat or tongue pain.

  • 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.

  • Sudden, permanent loss of vision in one eye.

  • 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.

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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:

  • 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.

  • Sex. Women are two to three times more likely to develop GCA than men are.

  • Race. Although GCA can affect people of any race, the vast majority are white. People of Northern European origin are particularly at risk.

  • 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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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
In no event will The DrEddyClinic.com be liable for any decision made or action taken in reliance upon the information provided through this web site.

 

 



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Last Modified : 05/14/08 07:40 AM