A typical rheumatologist in the UK actually treats more than just arthritis. Here in my Harley Street office, I treat a variety of rheumatological and autoimmune conditions, including many you have probably never heard of. Giant cell arteritis (GCA) is a good example.
GCA is a form of vasculitis sometimes referred to as temporal arteritis. The ‘temporal’ designation comes from the fact that one of the primary symptoms of the disease is inflammation of the blood vessels in the temporal region of the head.
Regardless of the name a doctor chooses to use, GCA is a serious condition that requires immediate treatment. If not treated, it can lead to serious consequences – including stroke and blindness.
Primary Symptoms of the Disease
GCA symptoms present differently depending on which arteries are affected. The most frequently observed symptoms are:
- pain and tenderness in the temples
- frequent headaches (often severe)
- jaw pain when talking or eating
- loss of vision in one or both eyes
- double vision
- flu-like symptoms (fatigue, weight loss, etc.).
In some cases, the symptoms are accompanied by visible inflammation. In other words, you can actually see the inflamed blood vessels underneath the skin. However, note that visible blood vessels alone are not enough to diagnose the disease.
How GCA Is Diagnosed
GCA is one of the most common forms of vasculitis in the UK. It is primarily observed in older patients over the age of 50. GCA is similar to other forms of vasculitis in the sense that a GP or rheumatologist cannot run a single test to find it.
A diagnosis usually begins with the observation of numerous symptoms and clinical signs. If a doctor suspects GCA, he or she can order blood tests that will show whether or not general inflammation is present. A positive blood test might lead the doctor to order a biopsy of the temporal arteries. As an alternative, ultrasound scans can sometimes provide the same information as a biopsy.
How GCA Is Treated
Since GCA can lead to things like vision loss and stroke, there are two goals for treatment. The first goal is to reduce inflammation so as to increase blood supply. The more inflammation can be brought under control, the lower the risk of serious complications. The second goal of treatment is to alleviate the symptoms.
We normally start with high dosage steroids to bring down inflammation. That lasts for a few weeks. We follow up with a reducing regime of steroids to keep things under control. This secondary part of treatment can go for as long as a couple of years. It really depends on how the patient responds.
If steroids are not enough, we can supplement with other treatments. Low-dose aspirin can reduce the risks of heart attack and stroke. Immunosuppressants can help to prevent inflammation from returning. Doctors sometimes turn to proton pump inhibitors and bisphosphonate therapy to counteract some of the unintended side effects of steroid treatment.
If you believe you are exhibiting the symptoms of GCA, please do not wait to be seen by a doctor. Contact your GP or reach out to my London Harley Street office urgently. As a rheumatologist offering private health consultations, I am well-versed in the symptoms of GCA. We can work together to figure out what is going on and get you on the right course of treatment.