Giant cell temporal arteritis, everything about the disease

Arteritis: description

A common name for a group of diseases caused by immunopathological inflammation of blood vascular. This reduces the vessel lumen, inhibiting blood flow, and formed the conditions for the formation of a blood clot. The latter may completely block the blood supply that leads to severe diseases. Also when inflammation increases the likelihood of the formation of the aneurysm.

Lesions amenable to all vascular: arteries, arterioles, veins, venules, capillaries.

1. Temporal arteritis or giant cell inflammation of the aortic arch. Suffering not only of the temporal artery, and other large vascular of the head and neck, but the symptoms are most visible on the artery.
2. Takayasu's syndrome - lesion of the aorta.
3. Arteritis of medium-sized vascular - nadasny polyarteritis and Kawasaki disease, affecting the coronary vascular.
4. Vasculitis of capillaries - polyangiitis, granulomatosis, and others.
5. Inflammation that affects any blood vascular - Cogan's syndrome, Behcet's disease (affects the blood vascular of the mucosa and skin).

There are also vasculitis of different organs, system, secondary. Most of them are accompanied by a strong fever.

Causes

To date remain unknown. The most obvious include age-related changes, if we are talking about diseases of the large vascular. With age the walls of the arteries and veins lose elasticity, which contributes to the appearance of immune inflammation.

However, this explanation can only lead to certain types of vasculitis. So, Behcet's disease, 3 times more often affects men in the age group of 20 to 30 years, and Kawasaki disease occurs in children up to 5 years.

There is a certain relationship with the work of hormonal system, as inflammation of the large arteries more susceptible to women.

Also according to medical statistics there is some genetic predisposition. Giant cell arteritis circulated to members of the white race. And Takayasu's syndrome suffer onlyAsian women up to 30 years. Systemic vasculitis affected equally representative of both European and Asian race, but living at latitudes 30 to 45 degrees in the middle East from Japan to the Mediterranean sea. These observations have not yet received an explanation.

There are primary and secondary form of arteritis.

1. Primary - vasculitis occurs as an independent phenomenon. As a rule, the inflammation is associated with age-related changes, on the basis of the fact that they suffer mostly people older than 50 years.
2. Secondary - inflammation is a consequence of another illness, usually an infectious disease in a severe form. The most dangerous are infections caused by Staphylococcus aureus and hepatitis b virus.

Symptoms

The disease is somewhat different from the common forms of vasculitis. The walls of the vessel forms a kind of complexes, multinuclear giant cells, hence the name. The defeat exposed the spinal and optic arteries, and celianna. The disease is autoimmune in nature: alien formations provoke the production of antibodies attacking the tissues of the vessel.

The picture shows manifestations of giant cell arteritis, click on pictures to enlarge.

In addition to the affected vascular and related organs. Damage to the optic artery drops dramatically visual acuity, at the stage of thrombus formation, there is complete blindness. With the defeat of the vertebral artery thrombus causing ischemic stroke.

The symptoms are as follows:

• sharp strong pain in the temple, radiating pain in the neck, in the area of language and even the shoulder. May be accompanied by partial or full temporary loss of vision, which indicates the damage of eye blood vascular;
• the symptom of pain has a pronounced pulsating character and is accompanied by painful throbbing of the arteries, easily felt on palpation;
• the pain in his temples intensified during mastication;
• the scalp from the damaged artery painful to the touch;
• observed drooping of the eyelid;
• double vision, blurred vision, sickness sensation in the eyes;
• the temple area, typically swollen, you may experience redness.

Disease not accompanied by fever, but the weight loss, loss of appetite and lethargy are noted.

Together with the temporal arteritis may show inflammation of the facial artery and rheumatic polymyalgia. The last is accompanied by the characteristic pain and stiffness in the muscles of the shoulder and pelvic girdles.

Diagnosis of disease

In this areaa consultant is a rheumatologist. Diagnosis includes clarification of the clinical picture based on the words of the patient and laboratory tests.

Bulging artery at his temple

• Blood test - high sed rate indicates the inflammatory processes. The second indicator, C-reactive protein, produced by the liver and in blood for inflammation and injuries. Both signs are indirect, but their level is a good indicator of when treatment.
• Biopsy - the research is a fragment of the artery. The symptoms of vasculitis coincide with symptoms of some other diseases, and diagnostics can more accurately identify the disease. If during the investigation of the drug detected multinucleated giant cells, the diagnosis is confirmed. It is worth noting that even the biopsies can not give a perfect result: cellular conglomerates are localized, and the chance that a sample will fall newspapery an artery, not too small.

Treatment

Treatment often begins before diagnosis completes. The reason is the severity of the consequences in delaying intervention, stroke, blindness and so on. Therefore, if the symptoms are pronounced, the course starts immediately after treatment.

Unlike many other inflammatory diseases temporal arteritis amenable to complete healing, although it takes a lot of time.

Treatment

When the diagnosis is not burdened with additional complications.

• Glucocorticoid drugs such as prednisone or cortisone. In the first phase the drug is administered in large doses. The improvement in the dose reduced, but the active treatment is at least 10-12 months. The treatment can last up to two years depending on the severity. When poor tolerability of the glucocorticoids used are methotrexate, azathioprine and other drugs, but the therapeutic effect is much lower. Prednisone is used in almost all kinds of arteritis and today is the most effective way.
• During the treatment, it is constantly blood. An important criterion for the diagnosis when vasculitis is the decrease in the level of erythrocytes and haemoglobin.
• With the threat of vision loss is assigned to pulse therapy of prednisone: the drug 3 days intravenously, then the patient receives the medication in tablet form.
• Vasodilators and sosudoukreplyayuschee tools preventing the formation of blood clots. To prevent the lattercan be added to Heparin as a subcutaneous injection.
• The composition of the blood in inflammation markedly affects the course of the disease. To improve its state of aggregation are used aspirin, chimes and the like.

Surgery

Treatment is indicated in cases where developing complications, such as thrombosis of the vessel, the formation of aneurysms, as well as with the presence of cancer.

In acute arterial obstruction resort to angioprotectivei or bypass. But such extreme cases are rare.

Prevention

Unfortunately, there are no measures to prevent temporal arteritis to do is impossible. In autoimmune nature of the disease the cells of the body is attacked by its own antibodies, but the mechanism of this phenomenon remains unclear. However, the implementation of General recommendations for strengthening the body and immune system reduce the risk of inflammation.

Temporal arteritis amenable to complete cure if timely treatment, and, most importantly, the implementation of a physician. The specificity of symptoms can quickly establish the diagnosis and the time to take action.