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Giant Cell Arteritis (GCA) or Temporal Arteritis

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The main early symptoms of Giant Cell Arteritis (GCA) are headache and tenderness over the sides of the forehead. People with GCA need urgent treatment with steroids, which will usually prevent serious complications such as eye problems and blindness.

• Known as 'giant cell' because abnormal large cells develop in the wall of the inflamed arteries.
  
  
• Commonly affects arteries around the head and neck.
  
  
• Most commonly affects the arteries to the sides of the forehead (temples), therefore sometimes called 'temporal arteritis'.
  
  
• GCA is uncommon, mainly affecting people over the age of 60 (very rare in people under 50).
  
  
• Women are more commonly affected than men.

The cause is not known.

What are the Symptoms?

• Headaches - sudden or gradual on one or both sides, mainly at the temples.
  
  
• Tenderness of the scalp area over the temples.
  
  
• Blood vessels at the temples - may look or feel prominent.
  
  
• Pain in the jaw or tongue when chewing or talking.
  
  
• Problems with vision - blurred vision, double vision or temporary sudden loss of vision.
  

If you have these symptoms, you should contact your doctor urgently.

People may also experience:

• Tiredness.
  
  
• Depression.
  
  
• Night Sweats.
  
  
• Fever.
  
  
• Loss of Appetite.
  
  
• Weight Loss.

Up to 50% of people with GCA also develop PMR (see section on Polymyalgia Rheumatica). Similar medications are used for both conditions.

What Tests are Needed?

GCA is likely if you have the typical symptoms and blood tests show a high level of inflammation, although some people with GCA and PMR have normal blood tests. Further tests are advised to confirm the diagnosis, which may include a small biopsy of the affected artery.

What is the Treatment?

Suspected GCA is usually treated immediately with a high dose of Prednisolone (steroid) to reduce the risk of complications and relieve headaches and other symptoms.

• Starting high dose of 40-60mg per day.
  
  
• Gradual reduction to maintenance dose of about 10mg per day (may take several months).

In some cases the condition goes away after 2-3 years, so medication may be stopped (under medical supervision).
But, for many people, treatment is required for several years, and sometimes for life.

Are there any Complications?

Complications are less likely if treatment is started immediately after onset of symptoms.

Untreated GCA could lead to the following possible complications:

• Blindness in one or both eyes.
  
  
• Inflamed artery and blocked blood supply.
  
  
• Very Rarely: Stroke or deafness.

News

GCA debate in the House of Lords – read how Lord Michael Wills of Swindon is drawing attention to the loss of sight through late diagnosis of GCA.

Resources

Giant Cell Arteritis - booklet Arthritis Research UK is a charity that funds high class research as well as educate and inform the general public about different musculoskeletal conditions. They released a booklet on Giant Cell Arteritis (GCA) which provides answers to questions about this condition. To read the booklet online, order a free copy or find out more information please visit the Arthritis Research UK website.