What is giant cell arteritis?
Giant cell arteritis or Horton’s disease – an inflammatory disease of the arteries. Giant cell arteritis is common in the elderly. The average age of onset – 70 years. 65% of patients – women.
What happens in the arteries?
Affected mostly large and medium-sized artery in the wall of the inflammatory process occurs, there is accumulation of abnormal (altered) cells – giant cells. This process covers the entire wall of the artery. There is thickening and swelling of the membranes of the arteries, causing narrowing the lumen of blood vessels, can be produced near-wall (along the walls of the arteries), blood clots. In the area of blood supply to the affected vessel blood flow disturbance develops, until its complete absence. Often the affected carotid artery (temporal, cranial), but it is possible involvement in the process of any of the arteries, which often goes unnoticed.
The causes of the disease
Causes of giant cell arteritis is unknown.
It is assumed viral etiology, such as viruses, influenza and hepatitis. There is a genetic predisposition (familial cases described). There is also a genetic predisposition: carrier set of HLA genes B14, B8, A10.
Symptoms of giant cell arteritis are divided into general, vascular and organ damage vision.
Common symptoms are:
– Febrile (body temperature of 38-39 degrees) fever,
– headache, sometimes very strong,
– Sharp pain in the face, numbness, tingling, aching in the masticatory muscles and tongue while eating or talking,
– Anorexia (no appetite),
– Weakness, weight loss,
– Sleep disturbance, depression,
– Giant cell arteritis may begin with symptoms characteristic of polymyalgia rheumatica: fever, malaise, muscle pain in the shoulder girdle, pains in the muscles of the pelvic girdle.
– Pain, swelling, redness, and induration of the temporal and parietal arteries, nodules on the scalp,
– Damage to other major arteries makes their symptoms (intermittent claudication, stroke, myocardial infarction, heart attacks internal organs).
The defeat of the vision:
In patients with giant cell arteritis noted transient blurred vision (the feeling of “fog” in front of the eyes), diplopia (double vision), and pain in the eye. Dangerous complication of giant cell arteritis, especially in untreated cases – ischemic optic neuropathy with decreased vision, until the sudden blindness. Usually the changes occur only in a few months after the onset of headache and visual impairment. If you pay attention to such complaints in a timely manner and prescribe treatment, blindness can be avoided.
In general, the prognosis of giant cell arteritis patients is favorable for life. Mortality in giant cell arteritis – is almost the same as in the general population.
However, there is a serious risk of various complications of the disease, especially arterial eye, leading to partial or complete loss of vision. Course of disease progression, but early treatment can lead to permanent remission.
What can a doctor do?
The doctor will conduct a thorough examination and prescribe the necessary examinations, which include examination of the fundus (fundus changes of the arteries), complete blood count (anemia, increased erythrocyte sedimentation rate), blood chemistry (hyper-alpha – and gamma-globulinemiya), a biopsy of the affected artery (identification of the giant cells).
Doctor will prescribe treatment, including prolonged use of high doses of hormones (corticosteroids).
Since the probability of deterioration is high, the patient should apply the corticosteroids for at least 2 years. With one-sided loss of vision corticosteroids administered immediately to save the other eye. When bilateral blindness, they are used only during exacerbations of the disease.