Giant Cell Arteritis: Symptoms, Risks and Why Prompt Treatment Matters

Giant cell arteritis is an inflammation of the arteries. MedlinePlus describes it as usually affecting arteries in the scalp, neck and arms; the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) notes that it especially involves the arteries on each side of the head, the scalp, and the aorta — the large artery carrying blood from the heart — and its main branches. Inflamed arteries narrow, so blood cannot flow well. The condition is also called temporal arteritis or Horton disease.

Who gets it

It almost always affects people over 50, typically in their late 60s and 70s, and it is more common in women than in men. It is more common in white people, especially those of Northern European ancestry, though it occurs in people of every background.

It is closely linked to another inflammatory disorder, polymyalgia rheumatica, which causes pain and stiffness in the shoulders, upper arms, hips and sometimes neck, usually worst in the morning or after rest. About 10 percent of people with polymyalgia rheumatica have giant cell arteritis, and about 50 percent of people with giant cell arteritis have polymyalgia rheumatica. Inflammation causes both, but what triggers it is not known.

Symptoms

Early symptoms can feel like the flu: tiredness, loss of appetite and fever, sometimes with weakness and weight loss. Other symptoms include:

• headaches and scalp tenderness, the most common — the headache is often severe and in the temples, and the scalp may be tender even before headaches start;
• pain in the jaw, especially when chewing, and in the tongue;
• vision problems, such as double vision or loss of vision in one or both eyes, which may at first last only minutes;
• dizziness, and problems with coordination and balance;
• large-artery problems — inflammation of the aorta and its branches can cause bulges (aneurysms) or, through blockages, cramping or aching in the arms or legs with activity; sometimes it causes no symptoms and is found by chance on a scan.

Symptoms usually develop over weeks or months, but sometimes come on suddenly.

Vision symptoms need treatment right away. Left untreated, they can lead to permanent vision loss within hours or days.

Diagnosis and treatment

There is no specific test. A doctor diagnoses it from the medical history, symptoms and a physical examination, and tests that measure inflammation may help.

Treatment is usually with corticosteroids. Early treatment matters, because without it there is a risk of permanent vision loss or stroke.

Sources

• MedlinePlus, U.S. National Library of Medicine, "Giant Cell Arteritis," drawing on NIAMS. https://medlineplus.gov/giantcellarteritis.html
• National Institute of Arthritis and Musculoskeletal and Skin Diseases, "Polymyalgia Rheumatica and Giant Cell Arteritis," used for the arteries involved, other names, who is affected, the overlap between the two disorders, symptom detail and timing: https://www.niams.nih.gov/health-topics/giant-cell-arteritis
• MedlinePlus says giant cell arteritis rarely comes back when properly treated, while NIAMS says symptoms commonly return when treatment is reduced or stopped; this page gives neither.
• Rewritten in hubnx's own words.