Temporal Arteritis
(Giant Cell Arteritis)
Definition
Temporal arteritis is a condition of inflammation of the arteries. It affects the head, neck, upper body, and arms. 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)—another name for temporal arteritis
- Vasculitis—a general term for swelling or inflammation of blood vessels
Temporal Arteritis
Causes
The cause of temporal arteritis is not known. It may result from an immune response in the body.
Risk Factors
Factors that increase your risk of temporal arteritis include:
- Age: 50 or older
- Race: White, especially of Scandinavian or northern European descent
- Location: northern latitudes
- Sex: female
- Family member with temporal arteritis
- Polymyalgia rheumatica , a condition characterized by stiffness and pain in muscles of the neck, shoulders, lower back, hips, and thighs
- Smoking and low body weight
Diagnosis
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Diagnosis is based on the occurrence of certain factors, including:
- Age: 50 or older
- New localized headache
- Temporal artery tenderness or decreased temporal artery pulse
- Sedimentation rate of 50 mm/hour or greater
- Abnormal temporal artery biopsy
- Anemia
Tests may include:
- Blood tests, including a sedimentation rate, c-reactive protein, hemoglobin, or hematocrit
- Biopsy —removal of a sample of the temporal artery for testing
- Retinal exam
- Ultrasound of the temporal artery
Treatment
Treatment may include:
Corticosteroid Therapy
This therapy is used to decrease the swelling and inflammation. It will also help decrease the risk of blindness. At first, high doses of prednisone are often given. The doses are then tapered off. Therapy is often continued for several years.
Calcium and Vitamin D Supplementation
Long-term use of corticosteroids has some harmful side effects. This may include:
- Osteoporosis —weakening of bones
- Diabetes —high glucose levels in blood
- Cataracts —clouding of the eye's lens
- Stomach irritation
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org/
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:
American Academy of Family Physicians website. Available at: http://www.aafp.org .
Karahaliou M, Vaiopoulos G, Papspyrou S. 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, Nordborg C, Odén A, Nordborg E. Early menopause, low body mass index, and smoking are independent risk factors for developing giant cell arteritis. Ann Rheum Dis. 2006;65:529-532.
Lawrence RC, Helmick CG, Arnett FC, et al. Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Arthritis Rheum. 1998; 41:778.
Nat Clin Pract Rheumatol . 2006;2:443-451.
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov .
Parikh M, Miller NR, Lee AG, 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.
Smetana GW, Shmerling RH. Does this patient have temporal arteritis?. JAMA. 2002; 287:92.
University of Southern California Department of Neurosurgery website. Available at: http://archsurg.ama-assn.org/cgi/content/full/139/11/1146 .
Last reviewed January 2009 by Jill D. Landis, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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