Giant Cell Arteritis

If you're a first time visitor you will probably have a number of questions about Giant Cell Arteritis. This is where I do my best to answer them. I am not a medical doctor, but I have spent many years researching PMR & GCA. I was also a polymyalgia sufferer for a number of years. My experience as a patient led me to write a best selling book on the subject, which is available here

If there is something you wish to know that is not answered here, then you may find the required information in the book or in the Articles page of this website. All information is based on current scientific research, although all opinions are my own and should only be used to supplement information and advice provided by a trained physician.

What is Giant Cell Arteritis?

Giant Cell Arteritis (GCA for short) is a form of vasculitis, an inflammatory condition of the arteries. It's not to be confused with arthritis as it affects a different part of the body.  What happens in GCA is that large cells form in the walls of the arteries taking blood to the head. Compared with normal cells these really are giants. Imagine comparing a child's birthday balloon with a hot air balloon and you get the picture.  The giant cells can block the blood flow around the head.  This can have a devastating effect, causing permanent loss of sight if blood supply to the optic nerve is interrupted. 
 
If you have been diagnosed and are on treatment for Giant Cell Arteritis, don't be too alarmed. The medication you are taking will be protecting your sight.  But if you think you might have GCA you should get medical attention immediately.
 
There is a clear link between Giant Cell Arteritis and Polymyalgia Rheumatica.  About one in four people with PMR also have symptoms of GCA, and almost half of people with Giant Cell Arteritis also have Polymyalgia Rheumatica. However, the precise nature of the link isn't yet clear. 
 
 

What are the symptoms?

The main symptoms of GCA are:
  • a severe headache that comes on suddenly, usually on one side of the head, and different from your 'normal' headache.
  • tender scalp - you might find it too painful to brush or comb your hair.
  • tenderness of the area around the temple, possibly with visual swelling of the artery just below the skin.
  • pain in the jaw on chewing that eases off when you stop chewing. You could have jaw pain while talking, too.
  • blurred or interrupted vision.
 
If you are suffering from three or more of these symptoms, and think you may have GCA you should seek medical help immediately.  If you are having momentary loss of vision, you must not lose any time. Giant Cell Arteritis can lead to permanent loss of sight if not treated, but this is completely preventable if treated promptly.

How is it diagnosed?

The only absolutely positive way to detect Giant Cell Arteritis is to find one of the giant cells.  Up to now, the way to do this has been to take a small biopsy from the temporal artery and examine it to see whether a giant cell is present. However, this isn't a totally reliable method, as many biopsies come back as false negatives.  The specialist is sure that the patient has GCA, but the pesky giant cell just didn't show up in the biopsy.  Recently, ultrasonic scanning has been used as an alternative method for tracing the abnormalities in the arteries, and this is preferable for a number of reasons.  It is more reliable than a biopsy, and of course it is less invasive.  It also provides more precise and accurate images that don't degrade.  Not all rheumatology departments in the UK are equipped to carry out the scans, because it requires special training for the technicians.  So you may not be offered the option.
 
As well as the biopsy, your doctor will carry out blood tests to determine the level of inflammation in the body.  It is important that anyone suspected of having GCA should be referred immediately to a rheumatology department as a medical emergency. 

How is it treated?

The standard treatment for Giant Cell Arteritis is to give the patient high doses of glucocorticosteroids, usually in the form of prednisolone. Usually there will be an almost immediate easing of the symptoms with a dose of 60mg.  The steroids force the giant cells to shrink and eventually disappear. Therefore it is vital that a biopsy or scan should be carried out before the steroids have obliterated the giant cells completely.  After a couple of weeks, the steroid dose will start to be reduced at regular intervals.  Steroid treatment will last at least a couple of years.