Synonyms
Arteriitis temporalis, arteriitis cranialis, horton arteriits, horton disease
Definition
Giant cell arteritis is one of the inflammatory diseases of the blood vessels. It thus belongs to the group of rheumatic diseases (rheumatism). Only the aorta and arteries are affected, but not veins or capillaries.
(Hence the name arteriitis = inflammation of the arteries. ) A distinction is made between two different forms:
- The classic form represents an inflammation of the temporal artery (lat. A. temporalis) running outside the head.
Typically, the entire carotid artery (lat. A. carotis), which runs from the collarbone region into the head, together with the arteries branching off from it, is involved in the inflammatory process. In rare cases, leg arteries or arteries of the viscera may also be affected.
- One form preferentially attacks the aorta and its large branches.
Epidemiology
The disease mostly affects older patients over 50 years of age. Women are more frequently affected than men. With about 30 new cases per year under 100,000 inhabitants, giant cell arteritis is the most common inflammation of the vessels (vasculitis). It occurs particularly frequently in combination with rheumatic diseases (rheumatism).
Causes
The cause of giant cell lateritis (Ateriitis temoralis Horton) is largely unknown. It is possible that predisposition (genetic disposition) plays a role. There is a connection with diseases in which the immune system is directed against the own body (autoimmune diseases = rheumatism; cf. Greek autos = self). The outbreak of the disease is promoted by bacterial or viral pre-damage of the vessels.
Symptoms
The main symptoms are headaches. The temporal artery on the skull is thickened (visible from the outside) and very sensitive to pressure. In most cases, only one side of the skull is affected, occasionally both the left and the right side are affected.
In general, there is a strong feeling of illness with fatigue, possibly fever, depression, loss of appetite and weight loss. In addition, signs of inflammation are detectable in the blood (increased blood sedimentation rate (BSG) and the C reactive protein (CRP)). Further complications occur as the disease progresses: Infection of the artery supplying the eye (ophtalmic artery) can lead to the occlusion of the vessel.
In this case, the eye (especially the retina, which is indispensable for visual impressions) is no longer supplied with blood, or not sufficiently so. The consequences range from impaired vision to blindness (in about half of all patients). Patients over the age of 65 often experience further complaints in the form of shoulder pain and/or morning stiffness of the limbs (known as polymyalgia rheumatica). The reason is an accompanying inflammation of the connective tissue lining the joints from the inside (the synovia, the inflammation is therefore called synovitis).
