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Understanding Giant Cell Arteritis: Causes, Symptoms, Diagnosis, and Treatment Options

William Wadzinski | MD

Medically reviewed by William Wadzinski | MD, Uniformed Services University of the Health Sciences on August 17th, 2023.

Key Takeaways

  • This autoimmune condition primarily strikes women over 50 of European descent, causing inflammation in the temporal arteries that can lead to irreversible blindness within days if untreated.

  • Classic symptoms include new-onset severe headaches in the temple area, jaw claudication (pain when chewing that forces you to stop), and visual disturbances like double vision or temporary vision loss.

  • Diagnosis requires a temporal artery biopsy showing characteristic giant cells and inflammation, plus an elevated ESR (erythrocyte sedimentation rate) typically over 50 mm/hr.

  • Treatment begins immediately with high-dose prednisone (40-60mg daily) before biopsy results, as delaying steroids even 24-48 hours increases risk of permanent vision complications.

  • About 50% of patients also have polymyalgia rheumatica, causing severe shoulder and hip stiffness, and the steroid taper typically lasts 12-24 months with careful monitoring for relapses.

Giant cell arteritis, also known as temporal arteritis, is an inflammatory disease that affects the large and medium-sized blood vessels in the head, particularly the temporal arteries. This condition can cause a range of symptoms and, if left untreated, may lead to serious complications such as vision loss. In this article, we'll explore the causes, symptoms, diagnosis, and treatment options for giant cell arteritis.

What Causes Giant Cell Arteritis?

Giant cell arteritis is an autoimmune disease, which means that the body's immune system mistakenly attacks healthy tissues. In this case, the immune cells target the blood vessels, causing inflammation and swelling. While the exact trigger for this condition is unknown, certain factors may increase your risk, including:

  • Being over 50 years old

  • Being female

  • Having a European ancestry, particularly Scandinavian

Symptoms of Giant Cell Arteritis

The most common symptom of giant cell arteritis is a severe headache, often felt in the temples and scalp. Other symptoms may include:

  • Fever

  • Fatigue

  • Jaw pain when chewing

  • Facial pain

  • Vision problems (blurred vision, double vision, or sudden vision loss)

  • Pain in the shoulders, arms, neck, and hip

  • Appetite loss and weight loss

  • Cough and sore throat

  • Tongue pain

If you experience any of these symptoms, it's essential to consult your doctor promptly.

The Link Between Giant Cell Arteritis and Polymyalgia Rheumatica

Approximately half of the people with giant cell arteritis also have polymyalgia rheumatica (PMR), an inflammatory condition that causes stiffness and aching in the arms, neck, lower back, and thighs. While the exact connection between the two conditions is unclear, they often occur together and can be treated with similar medications.

Understanding Giant Cell Arteritis: Causes, Symptoms, Diagnosis, and Treatment Options

Diagnosing Giant Cell Arteritis

To diagnose giant cell arteritis, your doctor will perform a physical exam, ask about your symptoms, and check for swelling and a weak pulse in the temporal artery. They may also recommend one or more of the following tests:

  • Temporal artery biopsy

  • Blood tests to check for inflammation

  • CT scan or MRI to examine the arteries in detail

  • Eye examination to check for vision-related complications

Treatment Options for Giant Cell Arteritis

Prompt treatment is crucial to prevent vision loss and other complications associated with giant cell arteritis. The main treatment involves high doses of steroids, such as prednisone, to reduce inflammation in the arteries. Most people need to take steroids for 1 to 2 years, with the dosage gradually reduced as the inflammation subsides.

Other treatment options may include:

  • Methotrexate, a drug used to treat cancer, rheumatoid arthritis, and psoriasis

  • Tocilizumab (Actemra), a biologic drug given as an injection to reduce the need for steroids

  • Aspirin to thin the blood and prevent clots

  • Calcium and vitamin D supplements, along with bisphosphonates, to prevent bone damage caused by long-term steroid use

Regular monitoring through blood tests and bone mineral density scans is essential to ensure the effectiveness of the treatment and to minimize side effects.

In conclusion, giant cell arteritis is a serious condition that requires prompt medical attention. By understanding the causes, symptoms, and treatment options, you can work with your healthcare provider to manage the disease effectively and maintain your quality of life. If you suspect that you or a loved one may have giant cell arteritis, don't hesitate to seek medical advice.

For more information on giant cell arteritis, visit:

The Bottom Line

Immediate high-dose steroid treatment is critical to prevent permanent blindness, even before confirming the diagnosis with biopsy. Any new severe headache with jaw pain or vision changes in someone over 50 requires urgent medical evaluation. If you're experiencing these concerning symptoms, Doctronic can help connect you with appropriate care quickly.

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