Diagnosis
To ensure the diagnosis can be included in the ultrasound examination or a magnetic resonance sonography of the head (MRI of the head). Magnetic resonance imaging can also be used to visualize the inflammatory changes in the vessel wall. However, a definite diagnosis of giant cell lateritis can only be made by taking a sample of the inflamed vessel (biopsy) and histological (fine tissue) examination. Further indications of Horton’s disease can be provided by blood tests with elevated inflammation values and, if necessary, detection of rheumatism – typical changes in blood laboratory values (e.g. rheumatoid factors or antinuclear antibodies (ANA)).
Therapy
The disease is serious, so therapy should be started immediately if there is a suspicion arising from the typical symptoms in order to prevent the disease from progressing. High-dose corticosteroids (cortisone) are given to reduce the inflammation. If the condition improves, the dose is then slowly reduced and continued for one to two years with as small doses as possible. Alternatively, the corticosteroids (cortisone) can be replaced in whole or in part by immunosuppressive drugs (e.g. methotrexate) in case of intolerance.
Prognosis
Without therapy, 30% of those affected go blind. However, if therapy is started immediately and consistently carried out, almost all patients are usually free of symptoms. Chronic precursors are an exception.
