|Temporal Arteritis by drdoc on-line|
Temporal arteritis is an inflammatory disease affecting blood
vessels with a granulomatous type of inflammation and resulting in a blockage of blood
supply to the area served by the vessels.
Scalp tenderness is common. The local vessels are thickened, and tender . Occasionally they are visible.
Visual disturbances have been seen in 2550% of cases.
Blindness is the most serious and irreversible feature. This can be sudden, painless and permanent. Involvement of the second eye can occur. Blindness may be the initial presentation of giant cell
Other symptoms include jaw discomfort when eating - due to a shortage in blood to the muscles of mastication (chewing), as a consequence of blockage of the affected blood vessels.
Corticosteroids are critical in the treatment of giant cell
arteritis; they reduce the incidence of blindness and rapidly relieve symptoms.
Non-steroidal anti-inflammatory drugs (NSAIDs) will lessen the painful symptoms, but they
do not prevent the blindness or vascular problems. The response occurs within days.
We use a starting dose of 40-60 mg of prednisone and cater the
dose to individual patients.
Most patients are on steroid approx. 2 years.
Unfortunately there are many side effects of high dose steroids. These include:
Since the condition is urgent with such severe potential consequence the patient must understand WHY the doctor is initiating these doses.
Steroid sparing drugs such as methotrexate have been used to try reduce the cortisone requirements and doses.
Evidence of temporal arteritis: painting by Jan Van Eyck (c. 13851440),
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