Sunday, December 11, 2005

arteritis giant cell (temporal arteritis)

arteritis, giant cell (temporal arteritis) - Giant cell arteritis, or temporal arteritis, is a condition characterized by proliferative granulomatous inflammation (many focal lesions) of the aorta and its major arteries. The cervical segments of the internal and external carotid arteries and the temporal, ophthalmic and occipital arteries are particularly affected. Those portions of the carotid and vertebral arteries that have a high elastic tissue content are most prone to be involved.
The cause of giant cell arteritis is unknown, and it is rarely seen before age 50. Women are affected more often than men. The most common symptoms are pain and tenderness in one or both frontal-temporal areas and diminished or absent pulsation over the temporal arteries. Headaches may be localized or radiate to the face, jaw, and neck. Tenderness of the scalp may cause sleeplessness from the head touching the pillow. Combing or brushing the hair may be intolerable. Intermittent claudication in the tongue is a common finding causing slurred speech.
Visual complications occur frequently as a result of severe ischemic optic atrophy (narrowing of the artery) or of occlusion of the central retinal artery. When diplopia (double vision) is present it is frequently indicative of potential visual loss. Fever, weight loss, and depression may precede local symptoms by several weeks. Joint pain may occur even earlier. A markedly high erythrocyte sedimentation rate (degree of rapidity with which the red cells sink in a mass of drawn blood) is the characteristic finding. Corticosteroid therapy should begin immediately. With adequate dosage, symptoms should subside within 48 hours. Treatment with maintenance doses is continued for 18 months but is often needed for much longer.
Brocklehurst, J. C. Textbook of Geriatric Medicine and Gerontology, 3rd ed. New York: Churchill Livingstone, 1985.

arteritis, temporal; See ARTERITIS, GIANT CELL.