This is a potentially serious condition where the arteries, particularly those at the side of the head (the temples) become inflamed. It requires urgent treatment as it can lead to vision being affected and inflammation in the major blood vessels of the body.
Symptoms of GCA
The symptoms depend on which arteries are affected.
Usual symptoms include
- new onset of frequent and severe headaches
- pain and tenderness over the temples
- jaw pain while eating or talking
- vision problems, such as double vision or loss of vision in one or both eyes
If you have problems with your vision, you should have a same-day appointment with an eye specialist (ophthalmologist) at a hospital eye department.
More general symptoms are also common – for example, flu-like symptoms, unintentional weight loss, depression and fatigue.
About 50% of people with GCA have polymyalgia (PMR) which causes pain, stiffness and inflammation in the muscles around the shoulders, neck and hips and buttocks.
Blood tests are helpful as they show inflammation with raised ESR and CRP and often anaemia. In addition, a temporal artery ultrasound scan will show typical changes to the blood vessel wall.
Treatment of GCA
Urgent treatment with steroids (prednisolone) is required to prevent visual loss or a stroke
Treatment will be started before the GCA is confirmed because of the risk to vision.
There are 2 stages of treatment:
- An initial high dose of steroids for a few weeks to help bring symptoms under control.
- A lower steroid dose (after symptoms have improved) given over a longer period, possibly 3 to 6years.
Regular follow-up consultations are needed to assess progress and check for any side effects to the medication. It is important not to suddenly stop taking steroids. Doing so could make you very ill.
Other types of medication you may need if you have GCA/temporal arteritis include:
- aspirin – to reduce the risk of stroke or a heart attack, which can occur if the arteries to your heart are affected. These may be given with a statin.
- proton pump inhibitors (PPIs) – to lower your risk of getting a stomach problem like indigestion or an ulcer, which can be a side effect of taking prednisolone
- bisphosphonate therapy – to reduce the risk of osteoporosis when taking prednisolone
- immunomodulatory therapy such as methotrexate, azathioprine, cyclophosphamide or mycophenolate to allow steroid medication to be reduced and help prevent a recurrence of GCA.
Dr Joel David at The Annexe, Summertown or Harley Street, London will diagnose and treat GCA.