What is Giant Cell Arteritis? Symptoms, Causes, & Treatment

Giant cell arteritis is a condition where the arteries in your head and neck become inflamed and swollen. This inflammation primarily affects the temporal arteries, which are the blood vessels that run along the sides of your head near your temples.

You might also hear doctors call this condition temporal arteritis because of where it most commonly occurs. The inflammation can make these arteries thick and tender, which reduces blood flow to important areas like your eyes, brain, and scalp.

What are the symptoms of Giant Cell Arteritis?

The most common symptom is a severe, throbbing headache that feels different from any headache you've had before. This headache typically affects one or both sides of your head, especially around the temple area.

Here are the main symptoms you might experience:

• Severe headache, usually in the temple area
• Scalp tenderness when brushing your hair or lying on a pillow
• Jaw pain or cramping when chewing or talking
• Vision problems, including blurred vision or double vision
• Fatigue and general feeling of being unwell
• Fever and night sweats
• Unintended weight loss
• Shoulder and hip stiffness

Vision changes deserve special attention because they can signal a serious complication. Some people experience temporary vision loss that comes and goes, while others might notice their vision becoming dim or shadowy.

In rare cases, you might develop sudden, permanent vision loss in one or both eyes. This happens when the inflamed arteries reduce blood flow to the optic nerve, and it's considered a medical emergency.

What causes Giant Cell Arteritis?

The exact cause of giant cell arteritis isn't fully understood, but doctors believe it happens when your immune system mistakenly attacks your own blood vessels. This autoimmune response triggers inflammation in the arterial walls.

Several factors may contribute to developing this condition:

• Age - it almost exclusively affects people over 50, with peak occurrence around 70-80 years
• Gender - women are about twice as likely to develop it compared to men
• Genetics - certain inherited traits may increase your susceptibility
• Geographic location - it's more common in Northern European populations and Scandinavian countries
• Infections - some researchers think viral or bacterial infections might trigger the condition in susceptible people

Environmental factors might also play a role, though researchers are still studying these connections. The condition tends to occur in cycles, with more cases appearing during certain seasons or years.

In rare instances, giant cell arteritis can be associated with other autoimmune conditions or develop alongside polymyalgia rheumatica, which causes muscle pain and stiffness.

When to see a doctor for Giant Cell Arteritis?

You should seek immediate medical attention if you experience sudden vision changes, severe headaches that feel different from your usual headaches, or jaw pain when chewing. These symptoms can indicate that the condition is affecting blood flow to critical areas.

Don't wait if you notice any vision problems, even if they seem to come and go. Vision loss from giant cell arteritis can become permanent if not treated quickly, so time is crucial for protecting your eyesight.

You should also contact your doctor if you have persistent symptoms like ongoing headaches, scalp tenderness, or unexplained fatigue along with other signs. Early diagnosis and treatment can prevent serious complications and help you feel better sooner.

What are the risk factors for Giant Cell Arteritis?

Age is the strongest risk factor for developing giant cell arteritis. The condition is extremely rare in people under 50, and your risk increases significantly as you get older, especially after age 70.

Several factors can increase your likelihood of developing this condition:

• Being female - women develop giant cell arteritis about twice as often as men
• Northern European ancestry - people of Scandinavian, Northern European, or Mediterranean descent have higher rates
• Having polymyalgia rheumatica - about 15-20% of people with this muscle condition also develop giant cell arteritis
• Family history - having relatives with autoimmune conditions may slightly increase your risk
• Certain genetic markers - specific inherited traits related to immune system function

Geographic location also matters, with higher rates reported in northern latitudes and certain regions like Minnesota and Scandinavia. However, the condition can occur anywhere and in any ethnic group.

In rare cases, people with other autoimmune conditions or those who have had certain infections might have a slightly elevated risk, though these connections are still being studied.

What are the possible complications of Giant Cell Arteritis?

The most serious complication is vision loss, which can happen suddenly and become permanent if the condition isn't treated promptly. This occurs when inflamed arteries reduce blood flow to your optic nerves or the arteries that supply your eyes.

Here are the main complications that can develop:

• Permanent vision loss in one or both eyes
• Stroke - if inflammation affects arteries supplying the brain
• Aortic aneurysm - weakening and bulging of the body's main artery
• Heart problems - including heart attack in rare cases
• Chronic pain and disability from ongoing inflammation

Vision complications can range from temporary episodes of dimmed vision to complete, irreversible blindness. About 15-20% of people with untreated giant cell arteritis experience some degree of vision loss.

Stroke is another serious but less common complication that can occur if the inflammation spreads to arteries supplying your brain. In very rare cases, the condition can affect the aorta, leading to aneurysms that develop years later and require monitoring.

The good news is that with proper treatment, most of these complications can be prevented or their risk significantly reduced.

How is Giant Cell Arteritis diagnosed?

Your doctor will start by asking about your symptoms and performing a physical examination, paying special attention to your temples and the temporal arteries. They'll feel for tenderness, swelling, or a reduced pulse in these arteries.

Several tests help confirm the diagnosis:

• Blood tests - checking for inflammation markers like ESR and CRP
• Temporal artery biopsy - removing a small piece of the artery for examination
• Ultrasound of the temporal arteries - looking for signs of inflammation
• Eye examination - checking for vision problems or optic nerve damage
• MRI or CT scans - in some cases to rule out other conditions

The temporal artery biopsy is considered the gold standard for diagnosis, though it's a minor surgical procedure. Your doctor will remove a small section of the temporal artery, usually under local anesthesia, and examine it under a microscope for characteristic changes.

Blood tests showing elevated inflammation markers support the diagnosis, but normal results don't rule out the condition. In rare cases where biopsy results are unclear, your doctor might use advanced imaging techniques or monitor your response to treatment.

What is the treatment for Giant Cell Arteritis?

Treatment begins immediately with high-dose corticosteroids, usually prednisone, to quickly reduce inflammation and prevent complications. Most people start feeling better within days of beginning treatment, though the full course typically lasts months to years.

Here's what treatment usually involves:

• High-dose oral prednisone (40-60mg daily) initially
• Gradual tapering of the dose over 1-2 years
• Regular monitoring with blood tests and eye exams
• Calcium and vitamin D supplements to protect bones
• Additional medications like methotrexate in some cases

If you're experiencing vision problems, your doctor might give you even higher doses of steroids initially, sometimes through an IV, to prevent permanent eye damage. The goal is to suppress inflammation as quickly as possible.

Your doctor will monitor your response through regular blood tests measuring inflammation levels and gradually reduce your steroid dose as the condition improves. This tapering process is carefully managed to prevent flare-ups while minimizing side effects.

In rare cases where steroids aren't effective or cause significant side effects, your doctor might prescribe additional immunosuppressive medications like methotrexate or tocilizumab.

How to manage home care during Giant Cell Arteritis treatment?

Taking your medications exactly as prescribed is the most important thing you can do at home. Don't stop or reduce your steroids without your doctor's guidance, even if you're feeling much better, as this can cause the condition to flare up.

Here are key self-care strategies:

• Take medications with food to reduce stomach irritation
• Monitor your blood sugar if you're diabetic, as steroids can raise glucose levels
• Eat a calcium-rich diet and take supplements as recommended
• Stay active with gentle exercise to maintain bone strength
• Get adequate sleep and manage stress
• Protect yourself from infections, as steroids can lower immunity

Watch for signs that your condition might be flaring up, such as returning headaches, vision changes, or jaw pain. Contact your doctor promptly if any of these symptoms return or worsen.

Since long-term steroid use can affect your bones, mood, and immune system, follow your doctor's recommendations for bone protection and infection prevention. Regular exercise, even just walking, can help maintain your strength and bone health.

How should you prepare for your doctor appointment?

Before your appointment, write down all your symptoms, including when they started, how severe they are, and what makes them better or worse. Be specific about any vision changes, headache patterns, or jaw pain you've experienced.

Bring a complete list of your current medications, including over-the-counter drugs and supplements. Also prepare information about your medical history, especially any autoimmune conditions or family history of similar problems.

Consider bringing a family member or friend who can help remember important information and provide support. Write down questions you want to ask, such as what to expect from treatment or how to manage side effects.

Don't hesitate to describe how your symptoms are affecting your daily life, work, or relationships. This information helps your doctor understand the full impact of the condition and tailor treatment accordingly.

What's the key takeaway about Giant Cell Arteritis?

Giant cell arteritis is a serious but very treatable condition when caught early. The most important thing to remember is that prompt treatment can prevent complications, especially vision loss, so don't delay seeking medical care if you have concerning symptoms.

With proper treatment, most people with giant cell arteritis can expect their symptoms to improve significantly and return to their normal activities. While treatment typically requires long-term medication, the outlook is generally very positive.

Stay connected with your healthcare team throughout treatment, follow your medication schedule carefully, and don't hesitate to contact your doctor if you have concerns. Your active participation in treatment is key to the best possible outcome.