Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Giant cell arteritis, also called temporal arteritis or cranial
arteritis, is a serious disease characterized by inflammation
of the walls
of the blood vessels (vasculitis). The vessels affected are the
arteries
(hence the name "arteritis"). Giant cell arteritis
occurs in
10%-15% of patients with polymyalgia rheumatica. The age of
affected
patients is over 50 years of age, identical to that of polymyalgia
rheumatica. The
onset of giant cell arteritis may be years before, after, or
without accompanying
polymyalgia rheumatica. The cause of giant cell arteritis is
not known. Recent research is looking into possible infectious causes, and some information suggests a possible relationship to the microbe Chlamydia. This will require further studies for verification.
What are symptoms of giant cell arteritis?
Because giant cell arteritis is commonly due to inflammation
of the
arterial blood vessels affecting the head, it frequently leads
to
headaches, pain in the jaw when repetitively chewing, and
tenderness of
the scalp (usually over the inflamed arteries of the sides of
the head). It is also commonly associated with fatigue,
low-grade
fevers, and weight loss. The muscle aching of polymyalgia
rheumatica is
seen in nearly half of the patients with giant cell arteritis, either
before, during, or after the onset of the arteritis.
When the arteries affected by giant cell arteritis become
inflamed, they
can narrow to the degree that the blood flow through them is
limited. This
can cause serious deficiency of oxygen supply to the tissues
normally
supplied by these arteries. Inadequate oxygenation of the eyes
or brain can
lead to impaired or double vision, blindness, or stroke. Less
commonly,
inflammation of the blood vessels supplying the arms can lead
to arm pain
when the arms are used.
Polymyalgia Rheumatica - Symptoms At Onset Of DiseaseQuestion: The symptoms of polymyalgia rheumatica can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
A stroke results from impaired oxygen delivery to brain cells via the bloodstream. A stroke is also referred to as a CVA, or cerebrovascular incident. Symptoms of stroke include: sudden numbness or weakness of the face, arm or leg. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, or loss of balance, and/or sudden severe headache with no known cause. A TIA, or transient ischemic attack is a short-lived temporary impairment of the brain caused by loss of blood supply. Stroke is a medical emergency.
Depression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
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