Giant cell arteritis is inflammation of the large arteries around the head.
It strikes almost exclusively after age 50, and if the swelling reaches the blood vessels feeding the eye, sight can disappear suddenly and without pain.
The American College of Rheumatology says permanent vision loss can occur suddenly, but that proper treatment usually prevents it.
The condition is also called temporal arteritis. It is the most common form of vasculitis, or blood-vessel inflammation, in older adults.
Also read: Heart rate variability by age: the ranges that reveal how well your body recovers
Cleveland Clinic estimates it affects about 19 to 23 out of every 100,000 people in the United States, most often between the ages of 70 and 80.
The problem is that its most distinctive early symptom is also the most ordinary complaint in primary care.
That symptom is a headache, and many people brush it off as tension or age.
The 7 warning signs to know
Watch for these symptoms if you are over 50. Any one of them, and especially a combination, is a reason to call a doctor without delay.
Also read: If you take Adderall or stimulant ADHD meds, these foods may cut how well they work
- A new, persistent headache. Usually a throbbing pain in one or both temples, but it can sit anywhere on the head. Cleveland Clinic describes it as a throbbing, continuous headache on one or both sides of your forehead.
- Jaw pain or cramping when you chew or talk. Known as jaw claudication, meaning the jaw muscles run short of blood supply during use. Mayo Clinic notes that vision loss is particularly likely in people who also have jaw pain.
- Sudden blurred vision, double vision or a brief loss of sight. Even a few seconds of vision change must be taken seriously.
- Scalp tenderness. Pain when combing hair or resting the head on a pillow, often felt over the temples.
- Unexplained fatigue or a flu-like feeling that will not lift.
- Unintentional weight loss or a sudden loss of appetite.
- Low-grade fever without an obvious infection.
Muscle aches in the shoulders, hips or upper thighs can also appear. They are tied to a related condition called polymyalgia rheumatica.
The ACR reports that 5 to 15 percent of patients with polymyalgia rheumatica go on to develop giant cell arteritis.
Why every hour counts
Any change in vision alongside these symptoms is a same-day emergency.
Mayo Clinic warns that once eyesight has been lost to giant cell arteritis, it is unlikely to return even after treatment begins.
Also read: Taking warfarin? These common foods could work against your medication
The American Academy of Ophthalmology urges anyone with these signs to be checked by an ophthalmologist right away.
Diagnosis usually starts with a blood test called the erythrocyte sedimentation rate, which measures inflammation. A biopsy of a small piece of the temporal artery often confirms it, and ultrasound is sometimes used as well.
The treatment that saves sight
The first-line drug is high-dose prednisone, a corticosteroid. Both the ACR and Cleveland Clinic list a typical starting dose in the range of 40 to 60 mg per day, followed by a slow taper.
The ACR notes that in May 2017, the biologic tocilizumab was approved for treating giant cell arteritis and can reduce the need for corticosteroids.
Also read: What time should you go to bed? The best bedtime based on your age
Cleveland Clinic reports that symptoms usually start easing within days of starting prednisone. But once vision has been lost, even prompt treatment rarely restores it.
That is why any new headache with a visual symptom after 50 belongs in an emergency room the same day, not a routine appointment the next week.
Also read: This is how stopping drinking alcohol can affect your body
This article is made and published by Mie Hermansen, who may have used AI in the preparation.