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.
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 - 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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