Giant Cell Arteritis (GCA), often called “temporal arteritis,” is a chronic and severe form of vasculitis, a condition in which blood vessels become inflamed. In people over 50, GCA is the most common form of vasculitis, affecting approximately 220,000 people in the United States.¹ Women are two to three times more likely to have GCA than men, and it is more common in people of Northern European descent. ¹

GCA is characterized by an inflammation of the blood vessels of the head, neck, arms and aorta. As the blood vessels become inflamed and swollen, the passage through which blood travels through the arteries can narrow and even close. Headaches are the most common symptom.¹ Other symptoms include unexplained fatigue, loss of appetite, weight-loss, jaw pain and scalp tenderness.^1,2

Partial or complete vision loss may occur in as many as 20 percent of GCA patients.² Research has also shown that patients with GCA may have higher risks for heart attacks, strokes and peripheral artery disease.⁴ Patients with GCA have an increased risk of death from complications of aortic aneursyms.⁵

Because GCA has a number of diverse symptoms, it can be initially difficult to diagnose, which can result in a delayed or incorrect diagnosis. Moreover, no single test is definitive. Due to the variability of symptoms, complexity of the disease and disease complications, people with GCA are often seen by several physicians including rheumatologists, ophthalmologists and neurologists.

There are, however, several tests your doctor may order to help diagnose GCA:

• If your doctor suspects you may have GCA, they may do a physical examination of your temporal arteries, as often one or both may be tender with a reduced pulse and a hard, cord-like feel.⁶
• Your physician may also check your erythrocyte sedimentation rate or “sed rate” through a blood test. This measures how fast the red blood cells fall to the bottom of the tube. A rapid drop can indicate inflammation.⁶
• Another blood test measures C-reactive protein (CRP), which is produced when there is inflammation.⁶
• Imaging tests may be used to diagnose GCA or monitor treatment, including magnetic resonance angiography (MRA) for detailed images of blood vessels, Doppler ultrasound for images of the blood flow through vessels, or positron emission tomography (PET) for images of blood vessels and areas of inflammation.⁶
• Another way to confirm GCA is through a temporal artery biopsy. It is an outpatient procedure with local anaesthesia. The sample will be examined for features of GCA, most notably abnormally large cells, called “giant cells.”⁶

Once GCA has been confirmed, you can take an active role in your healthcare by learning all you can about GCA, and keeping track of your symptoms to share information with your healthcare team.

^References

^{1. Borchers AT, et al. Giant Cell Arteritis: A review of classification, pathophysiology, geoepidemiology and treatment. Autoimmunity Reviews. 2012; 11:A544-5554.}

^{2. Bhat S, et al. Giant Cell Arteritis. Midlife and Beyond, GM. Rheumatology. February 2010; 071-079.}

^{3. Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States, Part II. Arthritis Rheum. 2008;58: 26-35.}

^{4. Tomasson G, et al. Risk for cardiovascular disease early and late after a diagnosis of giant-cell arteritis: a cohort study. Ann Intern Med. 2014;160(2):73-80.}

^{5. Kermani T, et al. Large-Vessel Involvement in Giant Cell Arteritis: A Population-Based Cohort Study of the Incidence-Trends and Prognosis. Annuals of Rheumatic Diseases. 2013: 72(12): 1989-1994.}

^{6. Ness T, Bley TA, Schmidt WA, Lamprecht P. The Diagnosis and Treatment of Giant Cell Arteritis. Deutsches Ärzteblatt International. 2013;110(21):376-386. doi:10.3238/arztebl.2013.0376}