Giant cell arteritis and polymyalgia rheumatica

What is giant cell arteritis?

Giant cell arteritis (also known as temporal arteritis) is a condition where there is inflammation of blood vessels, with the most commonly involved being those of the scalp and head, especially the temporal artery (an artery on the side of the head).

What is polymyalgia rheumatica?

Polymyalgia rheumatica (PMR) is an inflammatory condition characterised by pain and stiffness in the neck, shoulder and pelvic regions.

What causes these conditions?

The exact cause of these conditions is unknown, however both environmental and genetic factors are believed to play a role.

Both conditions are most likely to occur after the age of 50, and are most common between the ages of 70 and 80. They are rare under the age of 55 years. They are twice as common in women as in men. The conditions can occur together. In fact, about 50 per cent of people with GCA will have symptoms of PMR.

What are the symptoms?

GCA usually causes a new headache on one side of the head. Other symptoms can include fatigue, loss of appetite and weight loss. There may also be changes in your vision, such as blurred vision or loss of vision. If not treated early, GCA can lead to blindness, so it is very important to see your doctor straight away if you experience these symptoms.

In PMR there is usually aching and stiffness in the neck, shoulder and pelvic girdles. These symptoms are usually worse in the morning and after inactivity, especially at night. There may also be other symptoms, including fever, lethargy and weight loss.

How are polymyalgia rheumatica and giant cell arteritis diagnosed?

Diagnosis usually involves your doctor taking a history from you and performing a physical examination. Blood tests are also carried out to look for signs of inflammation (inflammatory markers). The best way of diagnosing GCA is to take a small biopsy (tissue sample) of the temporal artery.

What is the treatment?

The treatment for both GCA and PMR is a corticosteroid medicine, such as prednisone. Medication usually brings rapid relief of symptoms, and as the symptoms and levels of inflammatory markers improve, the dose can gradually be reduced. Higher doses are required to treat GCA than PMR.

Treatment is generally required for some time, often up to 2-3 years. There may be side effects from taking corticosteroids, such as high blood sugar levels and weakening of the bones (osteoporosis), however your doctor will check regularly for side effects during treatment.

Last Reviewed: 4 February 2013
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References

1. American College of Rheumatology. Giant cell arteritis. http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/giantcellarteritis.asp (accessed Feb 2013).
2. e Therapeutic Guidelines Complete. Polymyalgia rheumatica and giant cell arteritis. (accessed Feb 2013).
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