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November 23, 2009
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Polymyalgia Rheumatica (cont.)

How is giant cell arteritis diagnosed?

The diagnosis of giant cell arteritis is suspected when a patient over the age of 50 (usually over 60) develops symptoms above and/or suddenly develops blindness or stroke. The diagnosis is supported by signs of inflammation in the blood indicated by an elevation in the erythrocyte sedimentation rate (ESR) and/or C-reactive protein.

The diagnosis is confirmed with a biopsy of an artery, usually an artery on the side of the scalp called the temporal artery. This biopsy is performed under local anesthesia in an outpatient setting. It requires an incision into the scalp over the artery in the skin. The tissue of this area is supplied by blood from many vessels and does just fine after removal of the piece of the artery.

How is giant cell arteritis treated?

The goal of the treatment of giant cell arteritis is to suppress the inflammation within the arteries. When giant cell arteritis is diagnosed, high doses of cortisone medications, either intravenously or by mouth are necessary. The high doses required to quiet the inflamed arteries frequently are associated with side effects, including sweats, weight gain, bruising, puffiness of the face, erratic emotions, and others. (For more information about the effects of cortisone medications, please read the prednisone article.)

Also, in order to maintain optimal blood flow, low-dose aspirin is often given to optimize circulation of blood and prevent unwarranted blood clotting within diseased arteries. Recent studies have shown that low-dose aspirin can reduce the risk of stroke and visual loss in patients with giant cell arteritis.

As in the treatment of polymyalgia rheumatica, because the cortisone medications are associated with potential bone toxicity, causing osteoporosis, patients should consider calcium and vitamin D supplementation. Women should have bone mineral density testing, and osteoporosis medications, such as estrogen, alendronate (Fosamax), and risedronate (Actonel) are considered.



Next: What is the prognosis for patients with giant cell arteritis? »

Polymyalgia Rheumatica - Symptoms At Onset Of Disease

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The symptoms of polymyalgia rheumatica can vary greatly from patient to patient. What were your symptoms at the onset of your disease?

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