Temporal arteritis (giant cell arteritis) risk, relation to polymyalgia rheumatica

Temporal arteritis, also known as giant cell arteritis or GCA, is a rare autoimmune disease, but for the roughly 500,000 Americans who currently suffer from it, the condition can be further aggravated by its relation to another immune disorder.

Temporal arteritis or giant cell arteritis is inflammation and damage to the blood vessels that supply blood to the head, neck, upper body and arms. It can impact medium to large arteries. The inflammation, swelling and tenderness that come as a result of giant cell arteritis can be overwhelming.

In the majority of cases, giant cell arteritis occurs in the arteries around the temples that branch off from the carotid artery, which is in the neck. There are cases where the disorder can occur in the arteries in other parts of the body.

Temporal arteritis or giant cell arteritis and polymyalgia rheumatica, which is another inflammatory condition, have been linked. Medical data shows that polymyalgia rheumatica happens in an estimated 50 percent of people who suffer from giant cell arteritis. About 15 to 30 percent of people who start out with a diagnosis of polymyalgia rheumatica are later diagnosed with giant cell arteritis as well.

Who gets temporal arteritis and polymyalgia rheumatica?

The exact cause of polymyalgia rheumatica and temporal arteritis is unknown. It’s believed with temporal arteritis the body’s own immune system attacks blood vessels. When it comes to polymyalgia some theories include genetics and environmental triggers, such as infections. What we do know is who tends to get temporal arteritis and polymyalgia rheumatica.

Records show that people over 50 are most affected by these diseases. The average age of polymyalgia rheumatica and giant cell arteritis patients is 70. We also know that the disease is more common in women and Caucasians.

How are polymyalgia rheumatica and giant cell arteritis related?

Unfortunately, it isn’t clear how polymyalgia rheumatic and giant cell arteritis are related. Some people with polymyalgia rheumatica develop giant cell arteritis at the same time or they develop it after the musculoskeletal symptoms have gone away. In other cases, people with giant cell arteritis have polymyalgia rheumatica at some point while their arteries are inflamed.

When giant cell arteritis goes undiagnosed or untreated, it can cause other problems, including stroke and even permanent vision loss. This is why it is so important that doctors look for symptoms of giant cell arteritis in any patients who have already been diagnosed with polymyalgia rheumatica. Patients themselves are encouraged to pay close attention to any new symptoms that appear. Early detection and treatment can be crucial when it comes to preventing serious complications.

Diagnosis of temporal arteritis and polymyalgia rheumatica

Temporal arteritis and arthritis are not the same disorder and should not be confused. A person can have temporal arteritis or giant cell arteritis and arthritis at the same time. When a doctor suspects giant cell arteritis a temporal artery biopsy can be performed. Essentially, this involves removing a small section of the artery through an incision in the skin over the temple and examining it under a microscope. If the person has GCA there will be abnormal cells in the artery walls.

There are cases where people with GCA end up having a negative biopsy. Sometimes people who continue to show the typical symptoms of the disease, such as severe headaches, double vision, vision loss, dizziness, jaw pain, chest pain and persistent sore throat, will undergo a second biopsy.

A diagnosis of polymyalgia rheumatica is often based on medical history and symptoms. These symptoms could include aches or pains in the shoulders, stiffness in affected areas and limited range of motion in affected areas.

Some doctors will use lab tests to help them confirm what they suspect. For example, the most common test is an elevated erythrocyte sedimentation rate. It measures inflammation. An abnormal result shows tissue is inflamed, which can be a symptom for other disorders, including arthritis, so additional tests also have to be performed. To a large extent doctors will rule out other diseases, such as rheumatoid arthritis, before coming to a conclusion.

Treatment for temporal arteritis and polymyalgia rheumatica 

In the majority of cases both temporal arteritis and polymyalgia rheumatica are treated with corticosteroid medications, such as prednisone. For many years this type of treatment has shown to be the most affective at controlling the unpleasant symptoms associated with these two immune disorders. The corticosteroid medications allow most patients to enter into what is referred to as “clinical remission”. The downside is that some patient’s symptoms relapse when they decrease their medication.

Also, corticosteroid medications can have side effects, including fluid retention, weight gain, increased blood pressure, stomach irritation and an increase in infections. It is important to notify a doctor if any side effects arise.

When patients pay close attention to their symptoms and receive proper treatment, whether they have temporal arteritis, polymyalgia rheumatica or both, they can have a normal life span. The diseases can be controlled with guidance from qualified doctors. The success of treatment is really dependent on a prompt diagnosis along with regular follow-ups to make sure treatment side effects are minimized.