Giant Cell Arteritis and Polymyalgia Rheumatica
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What is giant cell arteritis?
Arteritis (say: “ar-ter-eye-tiss”) is a condition in which the arteries become inflamed (swell). Arteries are blood vessels that carry blood from the heart to the rest of the body.
Giant cell arteritis (GCA) can occur in the arteries of the arms, upper body and neck. However, 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.
What is polymyalgia rheumatica?
Polymyalgia rheumatica (say: “pol-lee-my-al-jah roo-matt-tick-ah”) is a condition in which the muscles in your neck, shoulders, hips and thighs become inflamed. This causes stiffness and aching in these areas. Polymyalgia rheumatica is also called PMR.
How are GCA and PMR related?
Between 10% and 20% of people who have PMR also have GCA, and 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.
What are the symptoms of GCA?
The symptoms of GCA include:
- Severe headaches
- Pain and tenderness in one or both temples
- Jaw pain, especially when chewing
- Double vision
- Vision loss
- Pain and stiffness in the neck and arms
- Unintended weight loss
What are the symptoms of PMR?
The symptoms of PMR include:
- Aching pain and stiffness in the neck, shoulders, hips and thighs
- General muscle weakness
- Unintended weight loss
CAUSES & RISK FACTORS
What causes these conditions?
No one knows what causes the inflammation associated with GCA or PMR. Problems with the immune system and aging are possible factors.
Who gets these conditions?
You are more likely to develop GCA and PMR is 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 diagnosed?
Often, a biopsy of the temporal artery is needed to confirm the diagnosis. For this biopsy, a small piece of the temporal artery is removed and looked at under a microscope. Your healthcare provider may also order blood tests to check for inflammation of the arteries and to rule out other conditions.
How is PMR diagnosed?
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.
How are these conditions treated?
For mild cases of PMR, your healthcare provider may recommend that you take an over‑the-counter nonsteroidal anti-inflammatory drug (NSAID). These medicines include aspirin, ibuprofen (some brand names: Advil, Motrin) and naproxen (one brand name: Aleve). However, NSAIDs are not effective in the treatment of GCA.
Your healthcare provider may prescribe a corticosteroid to treat the inflammation and pain associated with GCA and more severe cases of PMR. 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. Taking a corticosteroid for a long time can raise your blood pressure and your blood sugar levels, or weaken your bones. Your healthcare provider will need to keep checking you for these side effects during your treatment.
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.
QUESTIONS TO ASK YOUR HEALTHCARE PROVIDER
- What is the likely cause of my symptoms?
- Do I need any blood tests or biopsies?
- I have giant cell arteritis. Am I more likely to have polymyalgia rheumatica?
- I have polymyalgia rheumatica. Am I more likely to have giant cell arteritis?
- What is the best treatment for me? Do I need medicine?
- What are the risks and benefits of taking a corticosteroid?
Management of Giant Cell Arteritis and Polymyalgia Rheumatica by S Meskimen, M.S.N, TD Cook, M.S.N., and RL Blake, M.D. (04/01/00, http://www.aafp.org/afp/20000401/2061.html)