Giant Cell Arteritis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Giant cell arteritis is a condition where inflammation occurs in the lining of the arteries. Often, this condition involves the arteries in the head, especially in the forehead. For this reason, giant cell arteritis is often referred to as temporal arteritis.
This condition often causes headaches, tenderness in the head, pain in the jaw, and impaired vision. If you don’t get proper treatment, this condition can cause a stroke or blindness.
Handling with medication can generally help overcome complaints due to giant cell arteritis and prevent visual disturbances. Those who experience this problem can feel complaints that subside within a few days after starting treatment. However, even with treatment, there is a chance that the complaint will return.
Symptom
The most common sign and symptom of giant cell arteritis is headache and tenderness, which is usually severe and involves both sides of the forehead. In general, some of the signs and symptoms found in giant cell arteritis are:
- persistent and severe headache, usually on the forehead
- pressure pain on the head
- pain in the jaw when chewing or opening the mouth wide
- fever
- fatigue
- unplanned weight loss
- decreased vision or double vision, especially in those who also experience jaw pain
- permanent and sudden loss of vision in one eye
- pain and stiffness in the neck, back and pelvis are signs and symptoms of a condition associated with giant cell arteritis, namely polymyalgia rheumatism. About 50 percent of people who have giant cell arteritis also have polymyalgia rheumatism.
Reason
In giant cell arteritis, the lining of the arteries becomes inflamed, which then causes swelling. The swelling makes the blood vessels narrower and reduces the amount of blood flow. Thus, oxygen and nutrients that are vital to reach the body’s tissues are not optimal.
Almost all large and medium-sized arteries can experience this condition. However, swelling most often occurs in the arteries located on the forehead. Sometimes, swelling occurs only in part of the arteries, with also the presence of parts of the arteries that are still normal.
The cause of inflammation in this artery is not known with certainty. Certain genetic factors are said to increase the likelihood of experiencing the problem.
Several factors are thought to increase a person’s risk of developing giant cell arteritis, including:
- Giant cell arteritis occurs only in adults and often in those over 50 years of age. Most patients with this condition first show signs and symptoms between the ages of 70 and 80 years.
- Gender. Women are about twice as likely as men to experience this condition.
- Polymyalgia rheumatism. Someone with polymyalgia rheumatism (inflammation that causes pain and stiffness in muscles and joints. Usually stiffness and pain occurs in the muscles around the shoulders, neck and pelvis) has a higher risk of developing giant cell arteritis.
- Family history. Someone with a family history of giant cell arteritis also has a greater chance of experiencing this condition.
Diagnosis
Giant cell arteritis is sometimes difficult to diagnose because the early signs and symptoms mimic many other health conditions. Therefore, the doctor will try to rule out the possibility of other diseases first. This condition can be diagnosed through detailed medical interviews, direct physical examinations, and certain supporting examinations.
Some of the types of checks that can be done include:
- Physical examination. Apart from asking about your complaints and previous medical history, the doctor will also do a physical examination, especially looking at the temporal artery on the forehead.
Not infrequently, one or both forehead arteries are tender, with a slower pulse and a hard appearance and touch.
- Blood test. If you suspect that someone has giant cell arteritis, the doctor can ask that person to do a blood test.
One thing to check is the erythrocyte sedimentation rate, which is a test that measures the speed at which red blood cells fall to the bottom of a blood tube. Blood cells that fall quickly can indicate inflammation in the body.
In addition, the diagnosis can be strengthened by examining c-reactive protein (CRP). This is a substance produced by the liver when there is inflammation in the body.
- One way to confirm the diagnosis of giant cell arthritis is to take a small sample from the temporal artery.
This procedure can be done under local anesthesia. The samples taken were then further evaluated using a microscope. In those with giant cell arteritis, the arteries may show inflammation involving very large cells, called giant cells.
- Imaging examination. Imaging studies can be used to determine the diagnosis of giant cell arteritis and monitor response to treatment.
Several examination options that can be performed are magnetic resonance angiography (MRA), Doppler ultrasound, or positron emission tomography (PET).
Treatment
Handling giant cell arteritis usually requires corticosteroid treatment, which will be prescribed by a doctor after a thorough direct examination. Immediate treatment is important to prevent loss of sight.
Generally, complaints begin to subside a few days after starting treatment. Complaints related to vision can also subside within three months after getting treatment.
Treatment generally needs to be continued for one or two years and may take longer. The doctor can gradually reduce the dose to the lowest possible dose to control inflammation.
Occasionally, symptoms such as headaches may return when the dose is reduced. In such conditions, the dose can then be adjusted again by the doctor. In addition, your doctor may prescribe additional medication to help minimize side effects caused by corticosteroids.
Prevention
Because the cause of giant cell arteritis is not known with certainty, there are no methods that have proven to be completely effective in preventing this condition.