Causative & risk factors
Giant cell arteritis usually occurs in elderly people beyond the age of 70 years. Women are more likely to be affected. People belonging to certain races especially Northern Europeans are more likely to develop giant cell arteritis.
Clinical presentation
The patient typically presents with pain and tenderness in one or both the temples. He may have visual loss or double vision (diplopia). Facial pain and tenderness of the scalp will be present. The jaw pains while chewing or opening wide. Systemic symptoms like fever, fatigue, muscle pains and weight loss may be present.
Symptoms of polymyalgia rheumatica may be presnt in some patients with giant cell arteritis. These include soreness, stiffness and pain in several body structures such as the hip, neck, shoulders etc.
Involvement of other arteries will give rise to additional symptoms pertaining to that part.
The complications of aortic aneurysm include aneurysm, blindness, stroke or seizures.
Investigations
Blood tests are carried out to measure the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).
Imaging tests such as Doppler study, Magnetic resonance angiography (MRA) or Positron emission topography (PET scan) may be performed.
Giant cell arteritis can be confirmed by taking a biopsy of the affected artery.
Treatment
Corticosteroids form the mainstay of treatment for giant cell arteritis. Other medications include aspirin, proton pump inhibitors and supplements of calcium and vitamin D. Treatment may need to be continued for a period of up to 2 years.
