Giant Cell Arteritis: Symptoms, Causes & Treatment
التهاب الشرايين العملاقة
Giant cell (temporal) arteritis is inflammation of the walls of medium and large arteries, especially in the head and temple, affecting older adults. Its symptoms are a new headache, temple pain, jaw pain when chewing, and vision change. It is an emergency because it may cause vision loss and needs corticosteroids immediately.
What is Giant Cell Arteritis?
Giant cell arteritis, also known as temporal arteritis, is an inflammatory disease affecting the walls of medium and large arteries, especially the arteries in the scalp, temple, and neck. It usually affects older adults over fifty, increases with age, and is closely linked to polymyalgia rheumatica.
The inflammation causes swelling and narrowing of the artery walls, reducing blood flow to the tissues they supply. Its most prominent symptoms are a new, persistent headache especially in the temple area, pain or tenderness when touching the scalp, and jaw pain that appears when chewing (known as jaw claudication), in addition to general symptoms such as fatigue, low fever, weight loss, and muscle pain.
The most serious danger of this disease is its potential effect on vision: if the artery supplying the optic nerve is inflamed, sudden and permanent vision loss may occur in one or both eyes, a catastrophic but preventable complication. Giant cell arteritis is therefore a medical emergency: when it is suspected, treatment with high-dose corticosteroids is started immediately without waiting for all test results, because quick initiation saves sight. The diagnosis is confirmed by inflammation-marker tests and sometimes a temporal-artery biopsy or vascular imaging. Awareness of early symptoms in older adults, especially with polymyalgia rheumatica present, is extremely important.
Symptoms
- A new, persistent headache especially in the temple.
- Pain or tenderness when touching the scalp.
- Jaw pain when chewing (jaw claudication).
- Vision change or loss (a danger sign).
- Fatigue, low fever, weight loss, and muscle pain.
Causes
- Immune inflammation affecting the walls of medium and large arteries.
- The exact cause is unknown and increases with age.
- A close link to polymyalgia rheumatica.
Diagnosis
- Clinical assessment of the characteristic symptoms in older adults.
- Elevated inflammation-marker tests (ESR, C-reactive protein).
- A temporal-artery biopsy or vascular imaging to confirm the diagnosis.
Treatment
Immediate corticosteroids
- High-dose corticosteroids started immediately on suspicion without waiting, to save sight and prevent complications.
- Gradually tapering the dose over months to years with follow-up.
Supportive treatments
- Steroid-sparing biologic medications in selected cases.
- Protecting the bones from osteoporosis during prolonged treatment.
This content is educational and does not replace medical advice; the condition is an emergency.
Complications
- Sudden, permanent vision loss (the most serious complication).
- Stroke and large-vessel problems.
- Effects of prolonged corticosteroid treatment.
Prevention
- There is no prevention of the disease, but early detection and treatment save sight.
- Watching for symptoms, especially with polymyalgia rheumatica.
- Adhering to treatment and follow-up to avoid relapse.
When to see a doctor
Go to the emergency department immediately for a new severe headache, temple pain, or jaw pain when chewing, and especially for any sudden vision change in someone over fifty — vision loss here may be permanent and immediate treatment saves it. After urgent initiation, follow up with a rheumatologist on ClinicsJo.