Temporal Arteritis
(Giant Cell Arteritis)
Overview
Temporal arteritis,
also known as giant cell
arteritis, is an
inflammatory
autoimmune condition
affecting the
medium-sized blood
vessels that supply the
head, eyes, and optic
nerves that come out
from the eyes. The
disease usually affects
those over 60 years of
age and causes the blood
vessels in the forehead
and scalp to become
swollen and tender.
Women are approximately
4 times more likely to
suffer from this disease
then men.
The major concern with
temporal arteritis is
vision loss, although if
allowed to progress, it
may affect arteries in
other areas of the
body. This condition is
potentially vision
threatening, however, if
treated promptly,
permanent vision loss
can be prevented.
Vision is threatened
when the inflamed
arteries obstruct blood
flow to the eyes and
optic nerves. If
untreated, permanent
vision loss can occur
from oxygen deprivation
to the retina and optic
nerve.
Signs and Symptoms
Patients with temporal
arteritis usually notice
visual symptoms in one
eye at first, but as
many as 50% may notice
symptoms in the fellow
eye within days if the
condition is
untreated.
Detection and Diagnosis
When temporal arteritis
is suspected, the doctor
will order blood tests
including a erythrocyte
(red blood cell)
sedimentation rate (ESR)
and C-reactive protein
test. The ESR test
measures the time it
takes for the
erythrocytes to collect
in the bottom of a test
tube. The sediment
layer of erythrocytes is
measured in millimeters
and recorded. An
abnormally high ESR is
indicative of active
inflammation.
C-reactive protein is
produced in the liver.
This protein is released
when the body responds
to an injury or any
other event that signals
inflammation.
C-reactive protein is
measured with a blood
test.
A biopsy of the temporal
artery is usually
recommended. The
procedure is performed
with local anesthesia.
A small section of the
temporal artery is
removed and examined
under magnification for
inflammatory cells.
This test allows doctors
to definitively diagnose
temporal arteritis.
Treatment
The ophthalmologist
often works in
conjunction with the
patient's internist to
treat this disease. The
primary treatment for
the disease is oral
steroid medication to
reduce the inflammatory
process. Most patients
notice an improvement in
their symptoms within
several days. In some
cases, a long-term
maintenance dosage of
the steroid is
required.
For Management please
see part two
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