Polymyalgia Rheumatica (cont.)
What is the prognosis for patients with giant cell
arteritis?
Giant cell arteritis usually runs a self-limited course, over
months to
years. Rarely, the inflammation may not respond to high doses of
cortisone, and stronger medications that suppress the immune
system have
been tried, such as methotrexate. In most patients, the
cortisone
medications can gradually be tapered according to the
symptoms
while the ESR blood test is monitored.
The effects of the arteritis depend not only on the amount of
inflammation in the arteries but also on the location of the
arteries in
various body tissues. Recently, research scientists studying arteritis
have discovered that the location of the inflamed arteries in
the body and
whether it is associated with polymyalgia rheumatica seem to
relate to
different features of specialized white blood cells (T cells)
that are
infiltrating the artery walls. If these T cell differences can
be further
classified according to the patterns of inflammation in
patients, this
could lead to a new era of "customized" treatments
for giant
cell arteritis.
- Polymyalgia rheumatica causes pain and stiffness in muscles
and
joints.
- Polymyalgia rheumatica is diagnosed by characteristic symptoms
associated with
abnormal blood testing for inflammation.
- Polymyalgia rheumatica is treated with low doses of cortisone medications.
- Giant cell arteritis is a result of inflammation of
arteries.
- Giant cell arteritis can lead to blindness and/or stroke.
- Giant cell arteritis is detected by a biopsy of an artery.
- Giant cell arteritis is treated with high-dose cortisone medications.
References: Clinical Primer of Rheumatology, Lippincott Williams & Wilkens, edited by William Koopman, et al., 2003.
Kelley's Textbook of Rheumatology, W B Saunders Co, edited by Shaun Ruddy, et al., 2000.
Last Editorial Review: 3/13/2008
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