Giant cell arteritis (GCA), also known as temporal arteritis, causes inflammation of major arteries in the head, neck and arms. In this form of vasculitis, the arteries narrow, preventing blood flow to vital organs.
Left untreated, GCA leads to serious complications, including blindness and stroke.
Signs You Should Get Help for GCA
It is not known what causes giant cell arteritis. GCA might occur when a faulty immune system is triggered by environmental factors, such as an infection. You are more likely to get GCA if you are over 50 years old.
Giant cell arteritis causes a variety of symptoms, including the following:
- Throbbing headaches, especially at the temple
- Double or blurry vision, or vision loss
- Scalp tenderness
- Jaw pain with chewing
- Fever, night sweats
- Loss of balance
- Loss of appetite and weight loss
- Fatigue
- Muscle aches
If you have any of the symptoms listed above, visit your primary care doctor. Timely diagnosis and treatment are essential to preventing serious complications, like blindness, from giant cell arteritis. If we suspect GCA, you may be referred to a rheumatologist.
Giant Cell Arteritis Care at Rush
Diagnosis: The first step is getting your diagnosis right. After talking with you to get a good understanding of your symptoms, your Rush rheumatologist may order several tests to help confirm that you have GCA. The tests you receive may include the following:
- Blood tests to check your inflammation levels
- Imaging, such as a chest X-ray, CT scan or MRI, to see the extent of the damage in your blood vessels
- Biopsy of the temporal artery (blood vessels near your temples) to assess the damage
Often GCA and polymyalgia rheumatica, another inflammatory disorder, occur together. It's not clear why. The conditions share some symptoms, and we will test you for both.
Treatment: If you have GCA and it is treated quickly, your prognosis is generally good. With proper treatment, GCA rarely comes back.
Treatment at Rush focuses on controlling inflammation and preventing complications. We will develop a plan for you that may include the following:
- Initially, you will likely be given high doses of prednisone. The steroid dose typically is tapered over several months based on your response.
- Your rheumatologist may also recommend the drug Actemra (tocilizumab), which was recently approved by the Food and Drug Administration. It is given as a subcutaneous injection at Rush's Immunotherapy Infusion Service.
- You may also be placed on a low-dose aspirin regimen to prevent heart attack or stroke.
- You will also undergo a baseline bone density analysis to rule out osteoporosis, or bone fragility. Extended use of prednisone increases your risk of osteoporosis.
- You will need regular checkups with your doctor at Rush to monitor medication side effects and overall health.
- You may need yearly imaging tests to check on the aorta or other large blood vessels.
Rush Excellence in Giant Cell Arteritis
- Expert, compassionate providers: Rush rheumatologists are experts in diagnosing and treating all types of autoimmune conditions and musculoskeletal diseases, including giant cell arteritis. In addition to having extensive clinical knowledge, our rheumatologists are known for their compassionate exam-room manner. You'll find they spend as much time listening to you as they do talking.
- Team-based specialty care: To diagnose and treat your giant cell arteritis, you will likely need help from multiple specialists — all of whom are available at Rush. For instance, if you need a biopsy of your temporal artery, you can be referred to a Rush neuro-ophthalmologist or vascular surgeon. If your vision is affected by GCA, which occurs in about 70 percent of patients, then you can make an appointment with a Rush ophthalmologist. Your rheumatologist will work with all these specialists to ensure your care is well coordinated.
- Preventing bone problems: Our rheumatologists are careful to prevent osteoporosis in patients who take steroid treatments (prednisone) for giant cell arteritis. In addition to tapering you off prednisone as soon as possible, we will ensure that you get bone density tests. If you show signs of bone loss, we can refer you to Rush's Osteoporosis Center, which provides comprehensive treatment for osteopenia and osteoporosis.