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  • Temporal Arteritis

    (Giant Cell Arteritis)

    Definition

    Temporal arteritis is a condition of inflammation of the arteries. It affects the head, neck, upper body, and arms. The temporal artery is most often affected. It runs over the temple, to the outside of the eye. In extreme or untreated cases, this condition can lead to blindness or strokes. Two other terms often associated with this condition include:
    • Giant cell arteritis (GCA)—another name for temporal arteritis
    • Vasculitis—a general term for swelling or inflammation of blood vessels
    Temporal Arteritis
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    Causes

    The cause of temporal arteritis is not known. It may result from an immune response in the body.

    Risk Factors

    Factors that increase your risk of temporal arteritis include:
    • Age: 50 or older
    • Race: White, especially of Scandinavian or northern European descent
    • Location: northern latitudes
    • Sex: female
    • Family member with temporal arteritis
    • Polymyalgia rheumatica , a condition characterized by stiffness and pain in muscles of the neck, shoulders, lower back, hips, and thighs
    • Smoking and low body weight

    Symptoms

    Symptoms may include:
    • Headaches that are usually localized and one-sided
    • Fever or flu -like symptoms
    • Pain when chewing
    • Pain in the jaw or tongue
    • Scalp pain or tenderness over the temporal artery
    • Anemia
    • Fatigue
    • Loss of appetite and weight loss
    • Vision loss
    • Sweats
    • Aches in the joints or muscles

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.
    Diagnosis is based on the occurrence of certain factors, including:
    • Age: 50 or older
    • New localized headache
    • Temporal artery tenderness or decreased temporal artery pulse
    • Sedimentation rate of 50 mm/hour or greater
    • Abnormal temporal artery biopsy
    • Anemia
    Tests may include:
    • Blood tests, including a sedimentation rate, c-reactive protein, hemoglobin, or hematocrit
    • Biopsy —removal of a sample of the temporal artery for testing
    • Retinal exam
    • Ultrasound of the temporal artery

    Treatment

    Treatment may include:

    Corticosteroid Therapy

    This therapy is used to decrease the swelling and inflammation. It will also help decrease the risk of blindness. At first, high doses of prednisone are often given. The doses are then tapered off. Therapy is often continued for several years.
    Long-term use of corticosteroids has some harmful side effects. This may include: Supplements will help to stop these effects on the bone. The supplements may include:

    Low-Dose Aspirin

    Your doctor may recommend that you take low-dose aspirin every day. This may help to reduce the risk of vision loss associated with temporal arteritis.

    Prevention

    There is no known way to prevent temporal arteritis.

    RESOURCES

    American Academy of Family Physicians http://www.aafp.org/

    Arthritis Foundation http://www.arthritis.org/

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca/

    Canadian Society of Otolaryngology http://www.entcanada.org/

    References

    American Academy of Family Physicians website. Available at: http://www.aafp.org .

    Karahaliou M, Vaiopoulos G, Papspyrou S. Colour duplex sonography of temporal arteries before decision for biopsy: a prospective study in 55 patients with suspected giant cell arteritis. Arthritis Res Ther. 2006;8:R116.

    Larsson K, Mellström D, Nordborg C, Odén A, Nordborg E. Early menopause, low body mass index, and smoking are independent risk factors for developing giant cell arteritis. Ann Rheum Dis. 2006;65:529-532.

    Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998; 41:778.

    Nat Clin Pract Rheumatol . 2006;2:443-451.

    National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov .

    Parikh M, Miller NR, Lee AG, et al. Prevalence of a normal c-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis. Ophthalmology . 2006;113(10):1842-1845.

    Smetana GW, Shmerling RH. Does this patient have temporal arteritis? JAMA. 2002; 287:92.

    Temporal arteritis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 2009. Accessed February 10, 2010.

    University of Southern California Department of Neurosurgery website. Available at: http://archsurg.ama-assn.org/cgi/content/full/139/11/1146 .

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