Temporal arteritis, also called giant cell arteritis (GCA) is an inflammatory disease of blood vessels (most commonly large and medium arteries of the head). It is therefore a form of vasculitis. The name comes from the most frequently involved vessel (temporal artery which branches from the external carotid artery of the neck). The alternative name (giant cell arteritis) reflects the type of inflammatory cell that is involved (as seen on biopsy). Inflammation is the first response of the immune system to infection or irritation and may be referred to as the innate cascade. ... The arterial system The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Section of an artery An artery or arterial is also a class of highway. ... In medicine, vasculitis (plural: vasculitides) is a group of diseases featuring inflammation of the wall of blood vessels. ... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

The disorder may coexist (in one quarter of cases) with polymyalgia rheumatica (PMR), which is characterized by sudden onset of pain and stiffness in muscles (pelvis, shoulder) of the body and seen in the elderly. Other diseases related with temporal arteritis are systemic lupus erythematosus, rheumatoid arthritis and severe infections. Polymyalgia Rheumatica (PMR) - is disorder associated with pain in the shoulder and hip. ... Human male pelvis, viewed from front Human female pelvis, viewed from front The pelvis is the bony structure located at the base of the spine (properly known as the caudal end). ... In human anatomy, the shoulder joint is composed of three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humerus (upper arm bone) (see diagram). ... Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disorder that causes the immune system to attack the joints. ... An infection is the detrimental colonization of a host organism by a foreign species. ...

Symptoms

It is more common in females and after 50 years of age. Below this age it is extremely rare.

Patients present with:

• fever
• headache
• tenderness and sensitivity on the scalp
• jaw claudication
• reduced visual acuity (blurred vision)
• acute visual loss (sudden blindness)

The inflammation may affect blood supply to the eye and blurred vision or sudden blindness may occur. In 76% of cases involving the eye the optic nerve is involved causing anterior ischemic optic neuropathy. Loss of vision in both eyes may occur very abruptly and this disease is therefore a medical emergency. Fever, also known as pyrexia, is a medical symptom which describes an increase in temperature to levels which are above normal (37 degrees Celsius, 98. ... A headache is a condition of mild to severe pain in the head; sometimes upper back or neck pain may also be interpreted as a headache. ... The scalp is the skin on your head from which hair grows. ... The jaw is either of the two opposable structures forming, or near the entrance to, the mouth. ... Claudication, literally limping, is used as a medical term in various contexts. ... Visual acuity is the eyes ability to detect fine details and is the quantitative measure of the eyes ability to see an in-focus image at a certain distance. ... Visual loss results in the absence of vision where it existed before, which can happen either acutely or over a long period of time. ... An eye is an organ that detects light. ... Blindness can be defined physiologically as the condition of lacking sight. ... The optic nerve is the nerve that transmits visual information from the retina to the brain. ... Anterior ischemic optic neuropathy (AION) is a medical condition including loss of vision due to damage to the optic nerve. ... A medical emergency is an injury or illness that poses an immediate threat to a persons health or life which requires help from a doctor or hospital. ...

Diagnosis

Palpation of the head reveals sensitive and thick arteries with or without pulsation. Sedimentation rate is very high in most of the patients, but may be normal in approximately 20% of cases. The inflammation of the vessel must be demonstrated by removing a small part of the vessel (biopsy) and analysing it for giant cells infiltrating the tissue. Since the vessels are involved in a patchy pattern, there may be unaffected areas on the vessel and the biopsy might have been taken from these parts. So, a negative result does not definitely rule out the diagnosis. The erythrocyte sedimentation rate (ESR), also called a sedimentation rate, sed rate or Biernacki Reaction, is a non-specific measure of inflammation that is commonly used as a medical screening test. ... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

Treatment

Corticosteroids must be started as soon as the diagnosis is suspected (even before the diagnosis is confirmed by biopsy). In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ...

References

• U of Iowa Prof. Sohan Singh Hayreh's Giant Cell Arteritis article
• Polymyalgia rheumatica article from National Institute of Arthritis and Musculoskeletal and Skin Diseases
• eMedicine Neurology article on Temporal/Giant Cell Arteritis

External Links

• Giant cell arteritis