Giant cell or temporal arteritis is the most common type of vasculitis disorder and is characterized by inflammation of the lining of the arteries, particularly of temple arteries found in the head. The condition often results in headaches, scalp tenderness, jaw pain, and vision problems. If the condition is not properly treated in time, blindness or even stroke development may occur.
Giant cell arteritis in elderly linked to herpes virus causing chicken pox, shingles: study
Giant cell arteritis in elderly is linked to the herpes virus causing chicken pox and shingles. Giant cell arteritis is a condition where the blood vessels in the temples and scalp become inflamed, which can lead to sudden blindness or stroke.
Study author Don Gilden said, “Our analysis, which is the largest to-date, provides compelling evidence that the virus also reactivates in people over 60 in another way, triggering giant cell arteritis.”
Giant cell arteritis is the most common blood vessel inflammation in seniors, affecting nearly 29 out of 100,000 people.
The researchers examined 13 temporal artery biopsies of people who have died with no previous symptoms of giant cell arteritis and another 84 biopsies of people who had the condition to find evidence of chicken pox and shingles virus.
Varicella-zoster virus – herpes virus – was found in 74 percent of biopsies from the giant cell arteritis group and eight percent in the group without the condition.
In a corresponding editorial, Peter Kennedy wrote, “If the association in this landmark study can be replicated in other studies, clinical trials should focus on treating people with giant cell arteritis with a combination of the current steroid drugs used for the condition, plus antiviral treatment for the virus.”
Prevalence of giant cell arteritis
Giant cell arteritis is currently estimated to occur in 0.5 to 27 cases per 100,000 people aged 50 or older, with a higher incidence occurring in northern areas of the United States. The annual incidence in northern European countries has found that more than 20 cases per 100,000 people aged 50 or older. However, countries with lower life expectancies often see lower prevalence rates.
It is seen more commonly in women than in men, with a female-to-male ratio of 3.7:1. Smoking is considered a significant risk factor, as women who smoke have an approximate six-fold risk increase. Age is also a significant risk factor – the disease is quite rare in patients younger than 50 years old.
Giant cell arteritis symptoms, causes, and risk factors
The exact cause of giant cell arteritis is unknown, but researchers believe it is linked to the body’s autoimmune response. Furthermore, excessive dosages of antibiotics and certain severe infections have been noted to contribute to giant cell arteritis. Prevention is difficult because the exact cause is unknown. But once arteritis is detected, treatment can aid in reducing complications associated with the condition.
Symptoms of giant cell arteritis include:
- Double vision
- Sudden, permanent loss of vision
- A throbbing headache in the temples
- Loss of appetite
- Jaw pain, especially when chewing
- Unintentional weight loss
- Shoulder and hip pain or stiffness
- Tenderness of scalp and temple area
Giant cell arteritis is commonly seen in individuals over 50, so age is a large risk factor. Women are also more likely to develop giant cell arteritis compared to males. Whites of northern European or Scandinavian descent are at higher risk compared to other races.
Lastly, having a condition known as polymyalgia rheumatica or having a family history of giant cell arteritis also increases the risk of developing the condition.
Complications of giant cell arteritis
Giant cell arteritis complications include:
- Blindness: Caused by diminished blood flow to the eyes leading to sudden, painless, and permeant vision loss in one or both eyes (rare).
- Aortic aneurysm: Defined as a bulge that forms in a weakened part of a blood vessel. In the case of giant cell arteritis, a bulge of the aorta – a large artery that runs down the center of the chest and abdomen, may burst, causing a life-threatening internal bleeding.
- Stroke: Characterized by decreased blood supply to the brain, this complication rarely occurs in giant cell arteritis patients.
Giant cell arteritis prevention and home remedies
As mentioned, prevention for giant cell arteritis isn’t possible as researchers and doctors are still unaware of its cause. There are things you can do though to better manage the condition. The following tips can help cope with side effects from treatment medications and aid with symptoms.
- Eat a healthy diet: Can help prevent potential problems down the line such as thinning bones, high blood pressure, and diabetes. healthy diets often include fresh fruits and vegetables, whole grains, and lean meats and fish, while limiting salt, sugar and alcohol.
- Exercise regularly: By performing regular aerobic exercise, such as walking or running, you can prevent bone loss, maintain normal blood pressure, and even prevent diabetes. Exercise also helps improve mood and overall sense of well-being.
- Check in with your doctor regularly: If diagnosed with giant cell arteritis or any other medical condition for that matter, making sure to see your doctor on a regular basis will ensure you are staying healthy and avoiding any potential complications
- Discuss aspirin use: Taking low-dose aspirin may help reduce your risk of blindness and stroke. However, speaking to your doctor before any long-term treatment regimens will ensure it is safe for your current condition.
Giant cell arteritis treatment and diagnosis
Giant cell arteritis diagnosis
Giant cell arteritis diagnosis will typically begin with the recognition of symptoms. However, this initial step may be difficult as early symptoms can be difficult to spot.
One of the first steps is to perform a physical exam, which will focus on the temporal arteries of the head. These arteries may feel tender to the touch and have a reduced pulse.
The following are additional tests that may be ordered to confirm giant cell arteritis:
- Blood test: Used to check erythrocyte sedimentation rate (ESR), which may indicate an inflammatory process occurring the body.
- Biopsy: The best way to confirm giant cell arteritis that involves taking a small sample from the temporal artery. It is then examined under a microscope, looking for characteristic findings of giant cell arteritis.
Treating giant cell arteritis
The best form of treatment for giant cell arteritis is the prescription of corticosteroids. A common corticosteroid used in treatment is known as prednisolone, which may first be injected and later prescribed in tablets. Prednisolone may be taken for up to two years in order to eliminate and manage symptoms. Even though symptoms may disappear after a few days of taking the medications, it’s important that you follow through with the treatment as the symptoms may reappear.
Although corticosteroids like prednisolone are effective, they do come with side effects. Some common side effects of prednisolone include:
- Increased appetite and, in turn, weight gain
- Increase in blood pressure
- Mood changes
- Weakened bones
- Stomach ulcers
- Increased risk of infection
Other medications that may be prescribed are low-dose aspirin and immunosuppressants. As mentioned, regular follow-ups should be made with your doctor to prevent complications related to giant cell arteritis and to make any necessary changes to your medication. You should never stop taking a medication unless instructed otherwise by your health care provider.
Prognosis of giant cell arteritis
Symptom improvement and overall recovery is expected with prompt and adequate therapy of giant cell arteritis within just a couple of days of treatment. Early recognition and the prompt use of treatment in recent years has led to a reduced rate of neuro-ophthalmologic complications to the point that blindness is now a rare complication of this condition.
Those who do not seek treatment in a timely fashion, living with untreated giant cell arteritis, have an extremely poor prognosis. It is possible for these patients to suffer from irreversible blindness or even death from myocardial infarction, stroke, or dissection aortic aneurysm.