Symptoms include headaches and blurred or double vision, as a result of inflammation thickening the lining of affected arteries to such a degree that blood flow is reduced or blocked. If left untreated there’s a risk of blindness and stroke as a result of impaired blood flow to the eyes and brain.
Giant cell arteritis affects approximately 20 out of every 100,000 people over the age of 50 years. The incidence of this condition increases with age. It is seldom seen in anyone under the age of 50 years and the average age of onset is 70 years. It most commonly affects New Zealanders of Northern European decent and only rarely occurs in people of Asian descent. The condition is two to three times more likely to develop in women as it is in men.
The cause of giant cell arteritis is not fully understood. It is thought the inflammation may be due to an autoimmune reaction, where the body’s natural immune defenses mistakenly attack normal, healthy tissue.
Signs and symptoms
The condition usually begins with mild flu-like symptoms including mild fever and a persistent dull headache. Specific signs and symptoms will depend on which arteries are involved. These may include:
- Jaw pain - particularly when chewing
- Hearing problems
- Vision problems eg: blurred or double vision, loss of visual field
- Aching muscles about the neck and shoulders
- Loss of appetite
Giant cell arteritis is associated with a condition called polymyalgia rheumatica (PMR). PMR causes pain and stiffness in the muscles - particularly in the neck, shoulders and back. Approximately 15-25% of people with PMR also have giant cell arteritis.
A blood test that determines the red blood cell sedimentation rate (erythrocyte sedimentation rate or ESR) may also be performed. A raised ESR indicates inflammation in the body and it may be considerably raised when giant cell arteritis is present. This test can also be performed to help monitor the progression of the disorder.
High doses of corticosteroid medications are usually required until symptoms improve. After this initial period, the dosage is usually gradually decreased to the lowest dose at which symptoms are controlled. Treatment continues until the condition has completely resolved – in some patients this is as long as two to five years. Sometimes a low dose treatment is required indefinitely.
Non-steroidal anti-inflammatory medications (NSAID's), such as voltaren, may also be given in order to relieve any pain associated with the condition.
The symptoms of giant cell arteritis recur in approximately 30% of cases. In these cases high dose corticosteroid treatment will be resumed and medications to suppress the immune system may be prescribed.
Northland District Health Board Rheumatology Service (2007) Giant Cell Arteritis – information for patients and their families. (Fact sheet). Northland District Health Board. Whangarei.
Last Reviewed - 20 August 2013