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Temporal Arteritis

(Giant Cell Arteritis)

Definition

Temporal arteritis is inflammation of the arteries. It affects the arteries in the head, neck, and upper body. 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)
  • Vasculitis
Temporal Arteritis
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Causes

The cause of temporal arteritis is not known. It may result from an autoimmune response in the body. An autoimmune disease is a condition in which the immune system mistakes the body’s own tissue for a foreign invader, attacking and damaging it.

Risk Factors

Temporal arteritis is more common in women, and in people aged 50 years and older. It is also more common among Caucasians, especially those of Scandinavian or northern European descent. Other factors may increase your chance of getting temporal arteritis include:
  • Family history
  • Polymyalgia rheumatica—a condition characterized by stiffness and pain in muscles of the neck, shoulders, lower back, hips, and thighs

Symptoms

Temporal arteritis may cause:
  • Scalp pain or tenderness over the temporal artery
  • Headaches
  • Fever or flu-like symptoms
  • Pain when chewing
  • Pain in the jaw or tongue
  • Fatigue
  • Loss of appetite and weight loss
  • Vision changes
  • Sweats
  • Aches in the joints or muscles

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
  • Blood tests
  • Biopsy—removal of a sample of the temporal artery
  • Retinal exam
  • Ultrasound of the temporal artery

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

Corticosteroid Therapy

Corticosteroid therapy is used to decrease the swelling and inflammation. It will also help decrease the risk of blindness. At first, high doses 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. These 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 are no current guidelines to prevent temporal arteritis.

RESOURCES

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

Giant cell arteritis and polymyalgia rheumatica. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/giant-cell-arteritis-and-polymyalgia-rheumatica.html. Updated November 2010. Accessed August 7, 2013.

Karahaliou M, Vaiopoulos G, et al. 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, et al. Early menopause, low body mass index, and smoking are independent risk factors for developing giant cell arteritis. Ann Rheum Dis. 2006;65:529-532.

Parikh M, Miller NR, 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.

Polymyalgia rheumatica and giant cell arteritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Available at: http://www.niams.nih.gov/Health%5FInfo/Polymyalgia/default.asp. Accessed August 7, 2013.

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.ebscohost.com/about/about-us. Updated September 18, 2012. Accessed August 7, 2013.

Yellin AE, DeMeester TR. Department of Surgery, Keck School of Medicine, University of Southern California. JAMA Surgery. 2004;139(11):1146-1147.

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