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OVERVIEW

What is giant cell arteritis (GCA) and polymyalgia rheumatica?

 This condition causes inflammation of the arteries. Arteries are blood vessels that carry blood from the heart to the rest of the body. Arteritis is a condition in which the arteries become inflamed (swell). This reduces blood flow. Giant cell arteritis (GCA) causes certain arteries to become inflamed, red, hot, or painful. It usually affects the arteries that are above and in front of the ears on both sides of the head (the temples). This type of GCA is also sometimes called the temporal arteritis or cranial arteritis.

Polymyalgia rheumatica (PMR) is a condition involving inflammation of the muscles in your neck, shoulders, hips and thighs. This causes stiffness and aching in these areas.  It usually develops over time. But for some people, it can start as quickly as overnight. With treatment, PMR usually goes away within a year. It can last for several years in some cases. Both disorders mainly affect people over 50, particularly women.

How are GCA and PMR related?

About half of people who have GCA also have PMR. They can have these diseases at the same time, or GCA can develop after PMR.

SYMPTOMS

What are the symptoms of GCA and PMR?

The symptoms of GCA include:

• Flu-like symptoms. These can include fatigue, fever, and loss of appetite.
• Severe headaches
• Pain and tenderness in one or both temples
• Jaw pain, especially when chewing
• Double vision or vision loss
• Dizziness
• Pain and stiffness in the neck and arms
• Unintended weight loss

The symptoms of PMR include:

• Aching pain and stiffness in the neck, shoulders, hips and thighs
• Fatigue
• General muscle weakness
• Unintended weight loss

CAUSES & RISK FACTORS

What causes these conditions?

Healthcare providers aren’t sure what causes the inflammation associated with GCA or PMR. Aging and problems with the immune system are possible factors. It also could be related to your genes, or to an environmental trigger like an infection.

Who gets these conditions?

You are more likely to develop GCA and PMR if you are older than 50 years of age. They are most common in women between 70 and 80 years of age. For unknown reasons, Caucasian people are more likely to develop GCA and PMR than other races.

DIAGNOSIS & TESTS

How is GCA and PMR diagnosed?

To diagnose GCA, your healthcare provider will ask about your symptoms and examine the arteries in your temple. They will check if they are swollen or tender. They may order blood tests to check for inflammation of the arteries and to rule out other conditions. Often, a biopsy of the temporal artery is needed to confirm the diagnosis This is an outpatient procedure that involves removing a sample of your temporal artery from your scalp area.

To diagnose PMR, your healthcare provider will likely perform a physical exam and ask about your symptoms. They may order a blood test, which can help detect inflammation of your arteries and check your blood count. Your healthcare provider may also order a muscle biopsy to check for PMR.

PREVENTION

Can GCA and PMR be prevented or avoided?

There is no known way to prevent GCA or PMR because healthcare providers aren’t sure what causes them.

TREATMENT

Your healthcare provider may prescribe a corticosteroid to treat the inflammation and pain. These medicines are taken by mouth (in pill form). Once you start taking a corticosteroid, you should feel better quickly. You may need to take this medicine for up to 2 years.

What else can I do to ease the symptoms of these conditions?

Eating a healthy diet and getting enough exercise can help relieve the symptoms of both GCA and PMR.

Living with GCA and PMR

Taking a corticosteroid for a long time can raise your blood pressure. It can also increase your blood sugar levels or weaken your bones. Your healthcare provider will need to keep checking you for these side effects during your treatment.  Corticosteroids can cause other side effects. These include jitteriness, poor sleep, and weight gain. These symptoms usually get better as you take smaller doses of the medicine.

Getting early treatment for GCA is important. If inflamed arteries aren’t treated right away, they could be permanently damaged. This increases your risk of blindness or stroke. But with proper treatment, GCA and PMR may come back. About half of the time, though, a person who has PMR will experience at least 1 relapse.