Temporal Arteritis
Disease Details
Family Health Simplified
- Description
- Temporal arteritis, also known as giant cell arteritis, is an inflammatory disease affecting the large blood vessels of the scalp, neck, and arms, particularly the temporal arteries.
- Type
- Temporal arteritis, also known as giant cell arteritis, is primarily classified as an inflammatory condition affecting the blood vessels, particularly the large and medium arteries of the head. It is not typically characterized by genetic transmission; however, genetic predisposition can play a role. Specific genetic markers such as variations in the HLA-DRB1 gene have been associated with an increased risk, but the transmission is not Mendelian or straightforwardly hereditary. Environmental factors and aging are also significant contributors to the condition's development.
- Signs And Symptoms
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Common symptoms of giant cell arteritis include:
bruits
fever
headache
tenderness and sensitivity on the scalp
jaw claudication (pain in jaw when chewing)
tongue claudication (pain in tongue when chewing) and necrosis
reduced visual acuity (blurred vision)
acute visual loss (sudden blindness)
diplopia (double vision)
acute tinnitus (ringing in the ears)
polymyalgia rheumatica (in 50%)The inflammation may affect blood supply to the eye; blurred vision or sudden blindness may occur. In 76% of cases involving the eye, the ophthalmic artery is involved, causing arteritic anterior ischemic optic neuropathy.Giant cell arteritis may present with atypical or overlapping features. Early and accurate diagnosis is important to prevent ischemic vision loss. Therefore, this condition is considered a medical emergency.While studies vary as to the exact relapse rate of giant cell arteritis, relapse of this condition can occur. It most often happens at low doses of prednisone (<20 mg/day), during the first year of treatment, and the most common signs of relapse are headache and polymyalgia rheumatica. - Prognosis
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Temporal arteritis, also known as giant cell arteritis, is an inflammatory disease of the blood vessels that primarily affects the arteries of the head. The prognosis can be variable:
1. **Prompt Treatment**: With early and appropriate treatment, primarily glucocorticoids, many patients experience significant improvement and can prevent serious complications such as vision loss.
2. **Complications**: If left untreated, temporal arteritis can lead to irreversible complications, including permanent vision loss, stroke, or aortic aneurysm.
3. **Long-Term Monitoring**: Patients often require long-term treatment and regular monitoring to manage symptoms and adjust medication dosages to reduce potential side effects of prolonged steroid use.
Regular follow-up with a healthcare provider is essential to manage the condition effectively. - Onset
- Temporal arteritis, also known as giant cell arteritis, typically has a rapid onset over a few days to weeks. The condition primarily affects older adults, usually those over the age of 50, and is more common in women than men. Symptoms can include headaches, scalp tenderness, jaw claudication, and visual disturbances.
- Prevalence
- Temporal arteritis, also known as giant cell arteritis, primarily affects older adults, typically those over the age of 50. The prevalence varies by region and population but is generally estimated to be around 15-30 cases per 100,000 individuals annually in people over 50. It is more common in women than men and is most frequently seen in individuals of Northern European descent.
- Epidemiology
- Giant cell arteritis typically only occurs in those over the age of 50; particularly those in their 70s. It affects about 1 in 15,000 people over the age of 50 per year. It is more common in women than in men, by a ratio of 2:1, and more common in those of Northern European descent, as well as in those residing further from the Equator.
- Intractability
- Temporal arteritis, also known as giant cell arteritis, can be challenging to treat, particularly if there is a delay in diagnosis. While it can be managed effectively with corticosteroids and other immunosuppressive medications, treatment typically needs to be continued for an extended period to prevent relapse. Early detection and treatment are crucial to prevent serious complications such as vision loss. Therefore, while not necessarily intractable, it requires ongoing management and vigilance.
- Disease Severity
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Temporal arteritis, also known as giant cell arteritis, is a serious inflammatory disease of blood vessels, most commonly the temporal arteries.
If left untreated, it can lead to severe complications such as vision loss, stroke, or aortic aneurysm, making it a potentially life-threatening condition. Early diagnosis and treatment with corticosteroids can significantly reduce the risk of these severe outcomes. - Healthcare Professionals
- Disease Ontology ID - DOID:13375
- Pathophysiology
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Without further input, I'll provide information on the pathophysiology of temporal arteritis.
Temporal arteritis, also known as giant cell arteritis, is an inflammatory disease that primarily affects the large and medium arteries, particularly the temporal arteries. The exact cause is unknown, but it is believed to involve an autoimmune reaction. This immune response leads to the formation of granulomas with giant cells in the arterial wall, causing inflammation, narrowing, and sometimes occlusion of the affected vessels. This can result in reduced blood flow, leading to symptoms such as headaches, jaw claudication, and visual disturbances. If left untreated, it can cause serious complications, including permanent vision loss.
Please clarify what "nan" refers to if more information is needed. - Carrier Status
- Temporal arteritis, also known as giant cell arteritis, does not involve carrier status as it is not a genetic or hereditary condition. It is an inflammatory disease affecting the large blood vessels, primarily the temporal arteries, and is typically seen in older adults.
- Mechanism
- The pathological mechanism is the result of an inflammatory cascade that is triggered by an as of yet undetermined cause resulting in dendritic cells in the vessel wall recruiting T cells and macrophages to form granulomatous infiltrates. These infiltrates erode the middle and inner layers of the arterial tunica media leading to conditions such as aneurysm and dissection. Activation of T helper 17 (Th17) cells involved with interleukin (IL) 6, IL-17, IL-21 and IL-23 play a critical part; specifically, Th17 activation leads to further activation of Th17 through IL-6 in a continuous, cyclic fashion. This pathway is suppressed with glucocorticoids, and more recently it has been found that IL-6 inhibitors also play a suppressive role.
- Treatment
- GCA is considered a medical emergency due to the potential of irreversible vision loss. Corticosteroids, typically high-dose prednisone (1 mg/kg/day), should be started as soon as the diagnosis is suspected (even before the diagnosis is confirmed by biopsy) to prevent irreversible blindness secondary to ophthalmic artery occlusion. Steroids do not prevent the diagnosis from later being confirmed by biopsy, although certain changes in the histology may be observed towards the end of the first week of treatment and are more difficult to identify after a couple of months. The dose of corticosteroids is generally slowly tapered over 12–18 months. Oral steroids are at least as effective as intravenous steroids, except in the treatment of acute visual loss where intravenous steroids appear to offer significant benefit over oral steroids. Short-term side effects of prednisone are uncommon but can include mood changes, avascular necrosis, and an increased risk of infection. Some of the side effects associated with long-term use include weight gain, diabetes mellitus, osteoporosis, avascular necrosis, glaucoma, cataracts, cardiovascular disease, and an increased risk of infection. It is unclear whether adding a small amount of aspirin is beneficial or not as it has not been studied. Injections of tocilizumab may also be used. Tocilizumab is a humanized antibody that targets the interleukin-6 receptor, which is a key cytokine involved in the progression of GCA. Tocilizumab has been found to be effective at minimizing both recurrence, and flares of GCA when used both on its own and with corticosteroids. Long term use of tocilizumab requires further investigation. Tocilizumab may increase the risk of gastrointestinal perforation and infections, however it does not appear that there are more risks than using corticosteroids.
- Compassionate Use Treatment
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Temporal arteritis, also known as giant cell arteritis, primarily requires prompt treatment to prevent complications such as vision loss. The mainstay treatment is high-dose corticosteroids, typically prednisone. However, there are off-label and experimental treatments in certain cases.
1. **Tocilizumab**: An interleukin-6 (IL-6) receptor inhibitor usually approved for rheumatoid arthritis, tocilizumab has shown effectiveness in reducing symptoms and steroid dependency in patients with temporal arteritis. It is often used off-label in this context.
2. **Methotrexate**: This immunosuppressant is sometimes used off-label as a steroid-sparing agent. Evidence on its efficacy is mixed, but it may be considered in patients who struggle with long-term steroid use.
3. **Abatacept**: An immunomodulatory drug typically used for rheumatoid arthritis, it has shown promise in some studies for treating temporal arteritis and may be considered experimental in this use.
4. **Compassionate Use**: This is generally reserved for cases where conventional treatments are not effective or not tolerated. Experimental drugs not yet approved for temporal arteritis but showing potential in early studies might be accessible under compassionate use programs.
Always consult with an experienced healthcare provider to explore these options. - Lifestyle Recommendations
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For temporal arteritis, here are some lifestyle recommendations:
1. **Healthy Diet**: Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health.
2. **Regular Exercise**: Engage in low-impact exercises like walking, swimming, or cycling to maintain cardiovascular health.
3. **Avoid Smoking**: Smoking can exacerbate vascular conditions. Quitting smoking is highly advisable.
4. **Limit Alcohol**: Excessive alcohol can interfere with medications and worsen symptoms, so it's best to limit intake.
5. **Stress Management**: Practicing stress-reducing techniques such as meditation, yoga, or deep-breathing exercises can be beneficial.
6. **Medication Adherence**: Consistently follow the prescribed medication regimen, usually involving corticosteroids, and attend regular follow-up appointments with your healthcare provider.
7. **Monitor Symptoms**: Keep track of any new or worsening symptoms and report them to your doctor promptly.
8. **Regular Check-ups**: Maintain routine monitoring and check-ups to manage the condition effectively.
Implementing these lifestyle changes can help manage the symptoms and improve the quality of life for individuals with temporal arteritis. - Medication
- Temporal arteritis, also known as giant cell arteritis, is typically treated with corticosteroids, such as prednisone, to reduce inflammation. In some cases, immunosuppressive drugs like methotrexate or tocilizumab may be used as adjunct therapy or for patients who cannot tolerate corticosteroids. Prompt treatment is crucial to prevent complications like vision loss.
- Repurposable Drugs
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For temporal arteritis, also known as giant cell arteritis, some repurposable drugs include:
1. **Tocilizumab**: Originally used for rheumatoid arthritis, this interleukin-6 receptor inhibitor has shown effectiveness in treating temporal arteritis.
2. **Methotrexate**: Primarily used in cancer and autoimmune diseases, methotrexate may be used as a steroid-sparing agent in temporal arteritis.
3. **Abatacept**: Used for rheumatoid arthritis, this drug has potential benefits in managing temporal arteritis due to its immunomodulatory effects.
Consult with healthcare professionals for personalized medical advice and treatment plans. - Metabolites
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Temporal arteritis, also known as giant cell arteritis, involves inflammation of the blood vessels, particularly the temporal arteries. There isn't a direct list of specific metabolites exclusively associated with temporal arteritis. However, some biochemical markers and inflammatory mediators can be relevant in diagnosing and understanding the disease, such as:
- Elevated levels of C-reactive protein (CRP)
- Increased erythrocyte sedimentation rate (ESR)
- Interleukin-6 (IL-6)
- Tumor necrosis factor-alpha (TNF-alpha)
- Vascular endothelial growth factor (VEGF)
These markers are indicative of the inflammatory processes occurring in temporal arteritis. - Nutraceuticals
- The role of nutraceuticals in the treatment or management of temporal arteritis (giant cell arteritis) is not well-established in medical literature. Temporal arteritis typically requires prompt medical treatment with corticosteroids to prevent serious complications like vision loss. Always consult a healthcare professional before considering any supplements or alternative therapies for this condition.
- Peptides
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Temporal arteritis, also known as giant cell arteritis (GCA), is a condition involving inflammation of the temporal arteries which can lead to headaches, vision problems, and other symptoms.
Currently, the use of peptides in the treatment or understanding of temporal arteritis is not well established or documented in mainstream medical practice. The primary treatment for temporal arteritis typically involves corticosteroids such as prednisone to reduce inflammation and prevent complications like vision loss.
"Nan" could refer to various things, but if the intent is to understand the application of nanoparticles or nanotechnology in temporal arteritis, this area is still largely in experimental stages. Research may be ongoing to explore how nanotechnology can improve diagnosis or treatment, but there are no widely accepted nanotechnology-based treatments for temporal arteritis as of now.