Giant Cell Arteritis (GCA)
What is it?
Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions that destroy joints, bones, muscles, cartilage and other connective tissues, hampering or halting physical movement. Giant cell arteritis (GCA), also called temporal arteritis, is a type of vasculitis in which the walls of the medium-sized and large-sized arteries of the body become inflamed. This inflammation restricts blood flow through the affected blood vessels causing pain and sometimes more serious complications, such as blindness. GCA most often affects the arteries near the temple and those in the scalp, head, neck and arms.
What are the effects?
There are three subsets of giant cell arteritis (GCA) that have different sets of symptoms. Symptoms of the different subsets can overlap, however.
- Temporal arteritis: This subset of GCA primarily affects the branches of the carotid arteries that supply blood to the eyes and scalp. Of people with GCA, 80 to 90 percent will have these blood vessels affected.
- Headaches: Throbbing, sharp or dull headaches may bring you to your doctor.
- Tenderness near the temples: Noticed most when wearing glasses, combing hair or lying on a pillow.
- Amaurosis fugax: A fleeting visual blurring with heat or exercise, or posture-related visual blurring; it may precede partial or complete blindness and requires an emergency visit to the doctor.
- Blindness: Loss of vision is sudden, painless and usually permanent.
- Jaw claudication: Pain, tension and weakness of the muscles that allow you to chew and talk.
- Less common: Tongue, throat and neck pain
- Constitutional symptoms: In this subset of GCA, the disease process is dominated by manifestations of system-wide inflammation.
- Fever: Spiking temperature and chills will bring you to the doctor. Some people will have a low-grade fever instead.
- Malaise: The feeling of overall ill health and weakness.
- Loss of appetite and weight loss
- Large-vessel GCA: In 10 to 15 percent of people with GCA, the large arteries deeper inside the body are affected.
- Arm claudication: Pain, tension and weakness of the arm muscles, resulting in the arm becoming lame
- Absent or asymmetric pulses: The blood is not flowing through the vessels so the pulse cannot be felt, usually at the wrist or ankle
- Paresthesias: Strange burning and tingling sensations in the arms, legs or face.
- Raynaud’s phenomenon: Unusual sensitivity to cold in which your hands may hurt, become numb and turn blue or white in response to even moderately cold temperatures.
- Aortic aneurysm: The bulging with widening and weakening of a section of the aortic artery. You would feel no symptoms of this but your doctor would see it through angiography.
How is it diagnosed?
To determine if you have giant cell arteritis (GCA), your doctor will usually have you get a biopsy of a small piece of one of your affected arteries, usually the temporal artery which is above and just in front of the ear. In 20 to 30 percent of cases, the biopsy results will be negative. In these cases, your doctor may biopsy a different artery or may make the diagnosis of GCA based on other physical and laboratory tests.
What are the treatment options?
The symptoms of giant cell arteritis (GCA) are alleviated very quickly with the use of high doses of corticosteroids. Symptoms will usually greatly improve in 12 to 48 hours. Because blindness caused by GCA is permanent once it happens, your doctor may start you on corticosteroids even before the results of the temporal artery biopsy are available.
Expect to stay on corticosteroid treatment for many months to several years, but your doctor will likely lower the dosage once your symptoms are under control. Disease relapses occur during treatment in over 60 percent of patients, usually bringing on general malaise and flu-like symptoms rather than symptoms associated with blood vessel inflammation. If you have such a relapse, your doctor will raise your corticosteroid dosage again.
What resources are available?
The Arthritis Foundation leads the way in helping people with arthritis live better today and create better tomorrows through new treatments, better access and, ultimately, cures. We do this by:
- Funding life-changing research that has restored mobility in patients for more than six decades
- Fighting for health care policies that improve the lives of the millions of Americans with arthritis
- Partnering with families to provide empowering programs and information
If you are diagnosed with giant cell arteritis, some Arthritis Foundation resources that may help you better manage and live with your disease are:
- Learn more about arthritis treatments.
- Discover ways to make living with arthritis easier.
- Understand the causes of pain and the best ways to manage it.
- Discover what is happening with arthritis research.
- Help researchers find more effective treatments.
- Tell Congress more needs to be done for people with arthritis.