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Giant cell arteritis, also called temporal arteritis or cranial arteritis, is a serious disease that is characterized by inflammation of the walls of the blood vessels (vasculitis). The vessels affected are the arteries (hence the name "arteritis"). The diagnosis is confirmed with a biopsy of an artery, usually an artery on the side of the scalp called the temporal artery.
Polymyalgia rheumatica (PMR) is a disorder of the muscles and joints of older persons. It is characterized by pain and stiffness, affects both sides of the body, and involves the shoulders, arms, neck, and buttock areas.
Giant cell arteritis occurs in 10-15% of patients with polymyalgia rheumatica. The age of affected patients with these conditions is over 50 years. The onset of giant cell arteritis may be years before, after, or without accompanying polymyalgia rheumatica.
The cause of giant cell arteritis and polymyalgia rheumatica is unknown. Recent research has indicated that genetic (inherited) factors play a role in these diseases. Theories of causes have included viral stimulation of the immune system in genetically susceptible individuals.
Dr. Annette D. Wagner and colleagues at Medical School Hanover studied the temporal artery biopsies of 9 patients with giant cell arteritis, 4 patients with polymyalgia rheumatica, and 9 arteries from patients without either giant cell arteritis or polymyalgia rheumatica. The researchers were aware that respiratory infections are often present in the early stages of patients with giant cell arteritis and polymyalgia rheumatica. Furthermore, they appreciated that the Chlamydia pneumonia bacteria is a common cause of respiratory infections and used special methods to detect signs of this particular microbe.
The researchers discovered signs of Chlamydia pneumonia bacterium in the temporal arteries of 8 of 9 giant cell arteritis patients and one of 4 polymyalgia rheumatica patients. None of the 9 temporal arteries of patients without these diseases had signs of the bacterium.
The results of their study were published in the medical journal Arthritis & Rheumatism 2000; 43:1543-1551.
The researchers concluded that the Chlamydia pneumonia may play some role in giant cell arteritis and polymyalgia rheumatica. They further theorized that the bacterium may affect the arteries in the elderly because these arteries may have been damaged by atherosclerosis (hardening of the arteries), thereby creating a favorable environment for the bacterium.
While the exact role of the bacterium Chlamydia pneumonia in patients with giant cell arteritis and polymyalgia rheumatica is not clear, this is very exciting medical news. Currently, the treatment of giant cell arteritis and polymyalgia rheumatica typically involves cortisone-related drugs, which can have serious side effects. The results of this study could lead to new treatments, including antibiotics!
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