Giant cell arteritis Mate pona ngoikore pūtau rahi
Giant cell arteritis (GCA) is also called temporal arteritis. It is an uncommon but serious condition causing inflammation in the arteries of your head and neck. Very inflamed arteries can block the blood supply, sometimes causing permanent damage to your eyesight.
Giant cell arteritis and your vision
The most common arteries to be affected by giant cell arteritis are the temporal arteries. These are on each side of your forehead.
The arteries that supply blood to the eyes can be involved, and there is a risk of vision loss if giant cell arteritis is not treated quickly.
Symptoms of giant cell arteritis
Symptoms can include:
- a throbbing headache on one or both sides of your forehead that is often worse at night (the most common symptom)
- tenderness over your scalp or temple, especially when combing your hair or resting your head on a pillow
- pain in your jaw that worsens when you chew
- blurred vision, double vision or other vision problems, including flashing or colour changes.
You may have also noticed recent general unwellness including fever or tiredness, weight loss and not wanting to eat. These symptoms can appear well before a headache or other specific symptoms develop.
You may also have symptoms of polymyalgia rheumatica. This can include pain and stiffness, especially around your shoulders and hips. This happens in about half of the people who get giant cell arteritis.
Diagnosing giant cell arteritis
Your healthcare provider will ask you about your symptoms, examine your eyes and arrange a blood test to check for signs of inflammation.
If you have giant cell arteritis, your blood test will usually show signs of inflammation. Occasionally, your blood test can be normal when you have giant cell arteritis.
If your healthcare provider suspects giant cell arteritis you will have an ultrasound scan of the temporal arteries on each side of your face. The aim of this is to try to confirm the diagnosis of giant cell arteritis.
Rarely, you will also need a temporal artery biopsy. This short procedure involves a surgeon removing a small piece of the temporal artery on the side of your face. They will then look at it under a microscope to check for inflammation. This is normally done under a local anaesthetic in hospital.
Treating giant cell arteritis
If your healthcare provider thinks you may have giant cell arteritis, they will start you on high-dose steroid medication (prednisone) straight away.
Prednisone works by reducing the inflammation. You should feel an improvement within a few days. Your healthcare provider will monitor your symptoms and gradually reduce your steroid dose to the lowest dose that stops your symptoms.
Prednisone — My Medicinesexternal link
Giant cell arteritis can come back, so you may need to keep taking steroids for 1 to 2 years, perhaps longer.
Your healthcare provider may also start you on low-dose aspirin and a medication to protect your stomach.
Steroids can reduce your bone density and may cause osteoporosis. They can also cause weight gain.
Talk to your healthcare provider about what you can do to keep your bones strong and maintain your weight.
If your giant cell arteritis does not respond well to prednisone you may be referred to a specialist doctor (rheumatologist). They may consider other medications.