Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are related conditions. About 10 to 20 percent of people with PMR also have GCA.
Giant cell arteritis is an inflammation of the arteries or blood vessels in the arms, upper body and neck. Similarly, polymyalgia is an inflammatory disorder of the muscles of the neck, shoulders, hips, and thighs. Temporal arteritis, commonly used to refer to GCA, can develop after a person has acquired PMR.
Pain and stiffness caused by PMR peak in the morning and gradually taper off throughout the day. Pain is devastating that you can not do simple daily chores such as dressing up, taking a bath, picking up objects, or going inside your car.
Unfortunately, polymyalgia and temporal arteritis have no known causes. Age, race, sex and genetics are risk factors for having PMR. Problems of the immune system are also considered a risk factor.
Symptoms of GCA and PMR
Both diseases can be suffered simultaneously by a single patient. If you haven’t been diagnosed for polymyalgia, it is best to see a rheumatologist. He will order some laboratory tests and do a thorough physical check to get into the real problem. The symptoms will help your rheumatologist to determine if you have PMR; if you do, chances are you’ve also developed GCA.
Symptoms of giant cell arteritis
- severe headaches
- double vision or vision loss
- pain and stiffness in the neck and arms.
- pain and tenderness in the temple
- jaw pain
- weight loss
Symptoms of polymyalgia rheumatica
- muscle pain and stiffness in the neck, shoulders, arms, hips, thighs and buttocks
- low grade fever
- loss of appetite
- weight loss
Diagnosis of GCA and PMR
Giant cell arteritis and Polymyalgia rheumatica are diagnosed in different ways. Because it is an autoimmune disease, some symptoms are also similar to other immune disorders. Your rheumy will advise you to have blood tests to accurately diagnose your health issue.
Giant cell arteritis is detected through biopsy of the temporal artery. A portion of the temporal artery is observed under the microscope to confirm the existence of GCA in an individual. A blood test may also confirm the inflammation of the arteries while determining blood count.
PMR is diagnosed through a physical exam and also through a blood test. at your first visit, your rheumatologist will write a request for erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). These two are inflammation markers. Full or complete blood count is also done to check your white blood and red blood levels. A muscle biopsy is also used to detect PMR.
Treatment of GCA and PMR
Because GCA and PMR are inflammatory diseases, your rheumatologist will prescribe a corticosteroid. Steroid drugs are the most recommended medicine to relieve symptoms of giant cell arteritis and polymyalgia rheumatica, and all autoimmune diseases. Prednisone is a common oral steroid drug. It works effectively for both diseases as early after 2 days from starting medication. However, low-dose medication for PMR can reach up to 2 years to prevent relapse of pain, but GCA may require a higher dose of steroids. A corticosteroid has many side effects such that it is important to report to your doctor once in a while. Risky side effects of a steroid drug are diabetes, cataracts, osteoporosis and high blood pressure. A necessary exercise and a healthy diet can also lessen the symptoms of GCA and PMR.
Corticosteroids have many side effects. It is prescribed in tapered dose. Long-term use without your rheumy’s advice can be risky. It is important to see your rheumy regularly for a follow-up check. Some side effects of a steroid drug are diabetes, cataracts, osteoporosis and high blood pressure. Exercise and a healthy diet can also lessen the symptoms of GCA and PMR.
People who are aged 50 years and above are susceptible to these diseases. A significant number of persons with PMR and GCA are those in their 70s. women are most likely to acquire these diseases than men. Caucasians and those originally from northern Europe have the likelihood of developing GCA and PMR. However, any person of any race can acquire these immune meiated inflammatory conditions. Both vasculitic conditions require immediate diagnosis and treatment. Untreated GCA can cause irreversible blindness while PMR can cause severe pain if untreated. PMR can also cause permanent disability if left untreated.