Giant Cell Arteritis
What is Giant Cell Arteritis?
Giant Cell Arteritis is a condition that causes inflammation in the walls of medium and large arteries. It most often affects the temporal arteries, which run along the sides of your head near your temples. This inflammation can narrow or block blood flow through these vessels.
The condition gets its name from the giant cells that appear under a microscope when doctors examine affected tissue. It mainly affects adults over age 50, with most cases occurring in people over 70. Women develop this condition about twice as often as men.
Giant Cell Arteritis is serious because it can reduce blood flow to important organs. Without treatment, it can lead to vision loss or stroke. Early diagnosis and treatment can prevent these complications and help you maintain your quality of life.
Symptoms
- New headache, often in the temples
- Scalp tenderness, especially when brushing hair
- Jaw pain when chewing or talking
- Vision problems, including blurred vision or sudden vision loss
- Fatigue and general feeling of being unwell
- Fever, usually low grade
- Shoulder and hip pain or stiffness
- Unintended weight loss
- Night sweats
Some people experience only mild symptoms at first. However, sudden vision changes require immediate medical attention. About half of people with Giant Cell Arteritis also have a related condition called polymyalgia rheumatica.
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Causes and risk factors
Doctors do not know exactly what causes Giant Cell Arteritis. The condition appears to involve your immune system mistakenly attacking the walls of your arteries. Certain genetic factors may make some people more vulnerable. Environmental triggers might also play a role, though researchers are still investigating what these might be.
Age is the biggest risk factor, with nearly all cases occurring after age 50. Being of Northern European or Scandinavian descent increases your risk. Having polymyalgia rheumatica also raises your chances of developing this condition. Women face about twice the risk compared to men.
How it's diagnosed
Doctors diagnose Giant Cell Arteritis using several approaches. Your doctor will start with a physical exam, checking for tender arteries and other signs. Blood tests help identify inflammation in your body. Two common markers are erythrocyte sedimentation rate and C-reactive protein, which are usually elevated during active disease. Some specialized tests may measure inflammatory markers like Interleukin-6.
A temporal artery biopsy is often needed to confirm the diagnosis. During this procedure, a surgeon removes a small piece of the temporal artery to examine under a microscope. Imaging tests like ultrasound or MRI can also show inflammation in your arteries. Because vision loss can happen quickly, doctors often start treatment right away if they strongly suspect Giant Cell Arteritis, even before all test results return. Talk to your doctor about appropriate testing if you have concerning symptoms.
Treatment options
- High-dose corticosteroids like prednisone are the main treatment and usually started immediately
- Most people feel better within days of starting steroids
- Treatment typically lasts one to two years, with doses gradually reduced
- Biologic medications like tocilizumab may be added to help reduce steroid doses
- Low-dose aspirin to reduce the risk of vision loss and stroke
- Calcium and vitamin D supplements to protect bones during steroid treatment
- Regular monitoring with blood tests to track inflammation levels
- Eating a balanced diet rich in anti-inflammatory foods
- Staying physically active as tolerated
- Managing steroid side effects with help from your healthcare team
Frequently asked questions
A new headache is often the first symptom, typically affecting the temples. This headache may feel different from any headache you have had before. Many people also notice scalp tenderness, especially when combing their hair or resting their head on a pillow. If you are over 50 and develop unusual headaches, contact your doctor promptly.
Yes, Giant Cell Arteritis can cause permanent vision loss if not treated quickly. This happens when inflammation blocks blood flow to the optic nerve. Vision loss may occur suddenly in one or both eyes. This is why doctors treat suspected cases urgently, often starting medication before all tests are complete.
Giant Cell Arteritis headaches typically affect the temples and may worsen over time. You might notice scalp tenderness or jaw pain when chewing. Regular headaches do not usually cause these specific symptoms. Other signs like vision changes, fever, or unexplained fatigue alongside the headache suggest something more serious than a typical headache.
Doctors commonly check erythrocyte sedimentation rate and C-reactive protein, which measure inflammation in your body. These markers are usually high in people with active Giant Cell Arteritis. Some specialists also test Interleukin-6, another inflammatory marker. However, blood tests alone cannot confirm the diagnosis, so a temporal artery biopsy is often needed.
Most people take steroids for one to two years. Treatment starts with high doses, which your doctor will gradually lower over time. The tapering schedule depends on your symptoms and blood test results. Some people experience flares when doses are reduced and may need treatment adjustments.
About 40 to 60 percent of people with Giant Cell Arteritis also have polymyalgia rheumatica. This related condition causes pain and stiffness in the shoulders, neck, and hips. Both conditions involve inflammation and often respond to the same treatments. Having polymyalgia rheumatica increases your risk of developing Giant Cell Arteritis.
While lifestyle changes cannot cure Giant Cell Arteritis, they support your overall health during treatment. Eating nutrient-rich foods with anti-inflammatory properties may help. Regular gentle exercise maintains strength and mobility. Managing stress through relaxation techniques can also be beneficial. However, medication remains the essential treatment for this condition.
Yes, steroids can cause several side effects with prolonged use. Common issues include weight gain, high blood sugar, high blood pressure, and bone thinning. Your doctor will monitor you closely and may prescribe calcium and vitamin D to protect your bones. Some people take medications like methotrexate or tocilizumab to reduce the steroid dose needed.
People over age 70 face the highest risk, though the condition can occur anytime after age 50. Women develop it about twice as often as men. Those with Northern European or Scandinavian ancestry are more susceptible. Having polymyalgia rheumatica also increases your risk significantly.
Untreated Giant Cell Arteritis can lead to serious complications. Vision loss is the most concerning risk, potentially affecting one or both eyes permanently. Stroke can occur if inflammation affects arteries supplying the brain. Aneurysms may develop in weakened artery walls. This is why prompt diagnosis and treatment are critical.