Giant cell arteritis (GCA), or temporal arteritis, is a systemic inflammatory vasculitis of unknown etiology that occurs in older persons and can. This article reviews the diagnosis and treatment of the disease. Palabras clave. Arteritis de células gigantes, Vasculitis, Biopsia de arteria temporal. Keywords. Request PDF on ResearchGate | On Mar 1, , Jordi Camins-Fàbregas and others published Carotidinia y arteritis temporal de células gigantes.
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Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of other common conditions. For this reason, your doctor will try to rule out other possible causes of your problem.
Giant Cell Arteritis
In addition to asking about your symptoms and medical history, your doctor is likely to perform a thorough physical exam, paying particular attention to your temporal arteries. Often, one or both of these arteries are tender, with a reduced pulse and a hard, cordlike feel and appearance. The following tests might be used to help diagnose your condition and to follow your progress during treatment. These might be used to diagnose giant cell arteritis and to monitor your response to treatment.
The best way to confirm a diagnosis of giant cell arteritis is by taking a small sample biopsy of the temporal artery. This artery is situated close to the skin just in front of your ears and continues up to your scalp. The procedure is performed on an outpatient basis using local anesthesia, usually with little discomfort or scarring.
The sample is examined under a microscope in a laboratory. If you have giant cell arteritis, the artery will often show inflammation that includes abnormally large cells, called giant cells, which give the disease its name. It’s possible to have giant cell arteritis and have a negative biopsy result. If the results aren’t clear, your doctor might advise another temporal artery biopsy on the other side of your head.
The main treatment for giant cell arteritis consists of high doses of a corticosteroid drug such as prednisone. Because immediate treatment is necessary to prevent vision loss, your doctor is likely to start medication even before confirming the diagnosis with a biopsy.
You’ll likely begin to feel better within a few days of beginning treatment. If you have visual loss before starting treatment with corticosteroids, it’s unlikely that your vision will improve. However, your unaffected eye might be able to compensate for some of the visual changes. You may need to continue taking medication for one to two years or longer.
After the first month, your doctor might gradually begin to lower the dosage until you reach the lowest dose of corticosteroids needed to control inflammation. Some symptoms, particularly headaches, may return during this tapering period. This is the point at which many people also develop symptoms of polymyalgia rheumatica.
Such flares can usually be treated with slight increases in the corticosteroid dose. Your doctor might also suggest an immune-suppressing drug called methotrexate Trexall. Corticosteroids can lead to serious side effects, such as osteoporosis, high blood pressure and muscle weakness. To counter potential side effects, your doctor is likely to monitor your bone density and might prescribe calcium and vitamin D supplements or other medications to help prevent bone loss.
The Food and Drug Administration recently approved tocilizumab Actemra to treat giant cell arteritis. It’s given as an injection under your skin.
Side effects include making you more prone to infections. More research is needed.
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease. When giant cell arteritis is diagnosed and treated early, the prognosis is usually excellent.
Your symptoms will likely improve quickly after beginning corticosteroid treatment, and your vision isn’t likely to be affected. The following suggestions might help you manage your condition and cope with side effects of your medication:. Eat a healthy diet.
Eating well can help prevent potential problems, such as thinning bones, high blood pressure and diabetes. Emphasize fresh fruits and vegetables, whole grains, and lean meats and fish, while limiting salt, sugar and alcohol. Be sure to get enough calcium and vitamin D. Experts recommend 1, milligrams mg of calcium and international units IU of vitamin D a day for women over 50 and men over Check with your doctor to see what dose is right for you. Regular aerobic exercise, such as walking, can help prevent bone loss, high blood pressure and diabetes.
It also benefits your heart and lungs. In addition, many people find that exercise improves their mood and overall sense of well-being. If you’re not used to exercising, start out slowly and build up gradually. Your doctor can help you plan an exercise program. Learning everything you can about giant cell arteritis and its treatment can help you feel more in control of your condition.
Your health care team can answer your questions, and online support groups might also be of help. Know the possible side effects of the medications you take, and report gigantess changes in your health to your doctor.
You might start by seeing your primary care doctor.
He or she may refer you to an eye specialist ophthalmologist if you’re having visual symptoms, a brain gifantes nervous system specialist neurologist if you’re having headaches, or a specialist in diseases of the joints, bones and muscles rheumatologist. When you make the appointment, ask if there’s anything you need to do in advance.
For some tests involved in diagnosing giant cell arteritis, you might need to follow special instructions before the appointment. Ask your doctor if taking a pain reliever such as acetaminophen Tylenol, othersibuprofen Advil, Motrin IB, others or naproxen sodium Aleve might help ease head pain or tenderness. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version.
This content does not have an Arabic version. Diagnosis Giant cell arteritis can be difficult to diagnose because its early symptoms resemble those of other common conditions. Request an Appointment at Mayo Clinic. References Docken WP, et al. Clinical manifestations of giant cell arteritis. American College of Rheumatology. Diagnosis of giant cell arteritis.
Dejaco C, et al. Giant cell arteritis and polymyalgia rheumatic: Current challenges and opportunities. Genetic and Rare Diseases Information Center. FDA approves Genentech’s Actemra for giant cell arteritis.
¿Qué es la arteritis de células gigantes?
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