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Temporal ArteritisTemporal arteritis, or giant cell arteritis, is a common systemic vasculitis (inflammation of the blood vessels) of unknown etiology (cause) and was originally described as inflamed and swollen temporal arteries (on the sides of the forehead). In general, temporal arteritis can be thought of as a vasculitis involving medium-to-large arteries originating from the aorta. Although it was originally believed to be a rare entity, it is more commonly recognized today. Temporal arteritis occurs in an estimated 15-30 individuals per 100,000. It almost exclusively affects individuals older than 50 years and is believed to have a prevalence as high as 1 case per 500 individuals in this age group. An association between temporal arteritis and polymyalgia rheumatica (proximal muscle pain and stiffness for at least one month) is also thought to exist. 15 – 30 % of patients with PMR develop temporal arteritis and 30 - 50% of patients with temporal arteritis have PMR.PathophysiologyDiagnosis Temporal arteritis is more common in women and in the 7th decade of life and beyond. Diagnosis is supported by some blood tests such as: increased erythrocyte sedimentation rate, C-reactive protein, and platelet count. Diagnosis is confirmed by a temporal artery biopsy. If a high suspicion for temporal arteritis persists, the opposite side may be biopsied if the first temporal artery biopsy is negative. Symptoms Symptoms of temporal arteritis are a result of decreased blood flow, and can include:
Treatment Early therapy is critical to reduce the risk of arteritic anterior ischemic optic neuropathy (AION) in the opposite eye. Intravenous high dose steroids are started followed by a prolonged oral prednisone taper. Steroid-sparing medications, such as methotrexate, may be needed in those unable to tolerate steroids or patients who require long-term steroids. Temporal arteritis is co-managed with your internist or rheumatologist.
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