Giant cell arteritis (GCA)
What is it?
This is vasculitis, which affects large arteries, usually the temporal ones; the inflammation damages the arteries, causing them to narrow to an obstruction. This can affect the ocular arterial vessels and cause blindness. The disease was first described in 1890 by Dr. Hutchinson: a medical case concerned an eighty-year-old patient who could not wear a hat precisely because of pain associated with inflammation in the temporal region. Dr. Horton’s contribution was made in 1932, when he linked clinical signs with pathological changes. Horton also suggested the name “temporal arteritis”, which is often used in the scientific literature today.
Causes and risk factors
The disease affects people over the age of 50, whose average age is about 70 years. It occurs twice as often in women. The spread of the disease is approximately 200 people per 100,000.
The reasons are unknown.
Which are the symptoms?
Symptoms vary depending on the type of vascular lesion. However, the most frequent symptoms are:
- temporal lobe headache;
- visual impairment;
- oculomotor nerve paralysis;
- pain in the masticatory muscles when chewing;
- tingling in the scalp.
Constitutional symptoms such as fever, fatigue, weight loss, and anorexia are also possible.
Giant cell arteritis is often associated with rheumatic polymyalgia (50% of cases), the symptoms of which may precede, occur in parallel or follow arteritis.
How is it diagnosed?
The diagnosis is made when at least three of the following criteria are present at the same time:
- headache;
- pain or decreased pulsation of the temporal artery;
- detection of a characteristic inflammatory infiltrate in a temporal artery biopsy.
Another diagnostic criterion is the presence of an increased ESR index, the index of inflammation, in persons over 50 years of age.
Suggested exams
How is it treated?
Therapy is mainly based on the use of corticosteroids and should continue for a long time to avoid relapses. If good control of the signs of inflammation is not achieved, the use of immunosuppressants may also be recommended.
Where do we treat it?
Are you interested in receiving the treatment?