Giant cell arteritis or Horton’s disease is an inflammatory disease of the arteries. Giant cell arteritis is common in the elderly. The average age of onset is 70 years. 65% of patients are women. ? Mainly affects large and medium arteries. In their wall inflammation occurs, there is accumulation of abnormal (altered) cells – giant cells. This process covers the entire wall of the artery. Occurs thickening and swelling of membranes of the arteries, due to which narrows the lumen of blood vessels, can form near-wall (along the artery walls) clots. In the area of the blood supply of the affected vessel develops blood flow disturbance, up to its complete absence. Often affects the carotid arteries (temporal, cranial), but it is possible involvement in the process of any of the arteries, which often goes unnoticed. ?Causes of giant cell arteritis are unknown. It is possible a viral etiology, such as influenza virus and hepatitis. There is a genetic predisposition (described familial cases of the disease). There is also a genetic predisposition: set carrier gene HLA B14, B8, A10. ? Symptoms of giant cell arteritis are divided into general, vascular lesion and the organ of vision. Common symptoms are: ? – febrile (body temperature 38-39) fever; ? ? ? – headache sometimes very strong; ? – the sharp pain in the face, numbness, tingling, aching in the masticatory muscles and tongue while eating or talking; – anorexia nervosa; ?- weakness, loss of body weight; – sleep disturbance, depression; ? – giant cell arteritis may start with symptoms characteristic of rheumatic polymyalgia: fever, malaise, muscle pain shoulder, pain in the muscles of the pelvic girdle.Vascular symptoms: ? ?- tenderness, swelling, redness temporal and parietal arteries, nodules on the scalp; ? ?- the defeat of the other major arteries, gives his symptoms (stroke, myocardial infarction, heart attacks internal organs). ? ?The defeat of the vision: ? – giant cell arteritis patients noted transient blurred vision (sense of “fog” in front of the eyes), diplopia (double vision), and pain in the eye. ? ? ? ?- Giant cell arteritis dangerous complication, especially in untreated cases is ischemic optic neuropathy with decreased vision, until the sudden blindness. Usually, changes occur only in a few months after the onset of headache and visual impairment. If you listen carefully to the complaints in a timely manner and prescribe treatment, blindness can be avoided. ? In general, the prognosis of giant cell arteritis of life of patients is favorable. Mortality in giant cell arteritis – is almost the same as in the general population. However, there are serious risks of various complications of the disease, especially arterial disease eye, leading to partial or complete loss of vision. The disease progresses, but early treatment can lead to a stable remission. ? ?The doctor will conduct a thorough inspection, and appoint all necessary examinations, which include the examination of the fundus (fundus changes of the arteries), complete blood count (anemia, increased ESR), blood chemistry, a biopsy of the affected artery (Identification of giant cells). Doctor will prescribe treatment, including prolonged use of high doses of hormones ? (corticosteroids).?? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Since the probability of escalation is high, the patient should apply the corticosteroids, at least for 2 years. In unilateral loss of vision prescribed corticosteroids immediately to save the other eye. In bilateral blindness they apply only in exacerbations of the disease.
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