Understanding Giant Cell Arteritis: Symptoms, Causes, Treatment & Prevention
Giant cell arteritis is a condition in which the lining of the arteries become inflamed. When this happens, the arteries begin to swell and narrow, which makes it more difficult for blood to flow through them. And if blood is restricted, it is unable to carry oxygen and nutrients to bodily tissues, then those tissues may become damaged. As such, giant cell arteritis can lead to serious complications including blindness, aortic aneurysms and strokes if left untreated.
What Are the Types of Giant Cell Arteritis?
Giant cell arteritis can occur in almost any medium or large artery throughout the body. However, it most commonly affects the arteries within the temples, which are located on each side of the head, behind the eye and between the forehead and the ear. Giant cell arteritis is commonly referred to as temporal arteritis for this reason.
What Are the Causes & Risk Factors of Giant Cell Arteritis?
Giant cell arteritis occurs when the lining of arteries becomes inflamed, so the condition is a type of vasculitis. Researchers are still working to determine exactly what causes this to happen. However, studies suggest that giant cell arteritis may develop when a person’s immune system attacks the walls of their arteries, possibly due to genetic or environmental causes. As such, many members of the medical community believe that giant cell arteritis could be an autoimmune or autoinflammatory disease.
Having one or more of the following risk factors can increase a person’s chances of developing giant cell arteritis:
- Being over the age of 50 (most individuals with giant cell arteritis begin experiencing symptoms between the ages of 70 and 80)
- Being a woman
- Living though stressful events
- Having a family history of giant cell arteritis
Notably, research shows that there may be a correlation between giant cell arteritis and polymyalgia rheumatica, an inflammatory condition that can cause pain and stiffness in the neck, shoulders and hips. In fact, approximately half of the individuals who have giant cell arteritis also have polymyalgia rheumatica.
What Are the Symptoms & Warning Signs of Giant Cell Arteritis?
The symptoms of giant cell arteritis can vary depending on where the resulting inflammation is located within the body. For example, when giant cell arteritis causes the arteries within the temples to become inflamed, it can produce severe pain and tenderness in that area. This pain is often described as a throbbing headache, and it may be intermittent or progressively worsen. Because the temporal arteries also supply blood to the scalp, optic nerves and jaw muscles, temporal arteritis can also cause scalp tenderness, vision problems (e.g., blurred vision, double vision or vision loss) and jaw pain (especially when chewing or opening the mouth wide).
Other common symptoms of giant cell arteritis include:
- Fever
- Fatigue
- Muscle aches
- Reduced appetite
- Unexplained weight loss
Many people who have giant cell arteritis also have polymyalgia rheumatica. If you have this related condition, you may also experience pain and stiffness in your neck, shoulders and hips.
When to See a Doctor for Giant Cell Arteritis
Giant cell arteritis always requires immediate medical care, and early treatment can improve a person’s chances of preserving their vision. So, if you’re experiencing any of the giant cell arteritis symptoms listed above, be sure to reach out to a physician as soon as possible.
At Tampa General Hospital, we have extensive experience treating giant cell arteritis and other cardiac (heart) and vascular (artery and vein) conditions, and we’ll diagnose precisely what’s causing your symptoms and create a customized treatment plan for you.
When to Seek Emergency Treatment for Giant Cell Arteritis
While you should immediately reach out to a physician about a suspected case of giant cell arteritis, this condition typically doesn’t require emergency treatment. However, it’s important to remember that giant cell arteritis can lead to serious complications like blindness, aortic aneurysms and strokes. If you experience any of these complications or any other potentially life- or limb-threatening condition—for example, a heart attack—be sure to call 911 or get to a hospital as soon as possible.
Diagnosis & Tests for Giant Cell Arteritis
If your physician suspects that you have giant cell arteritis, they’ll likely begin by reviewing your personal and family medical histories and asking you questions about the symptoms you’ve been experiencing. For example, they’ll want to know:
- What your symptoms include
- When your symptoms began
- What you were doing when your symptoms started
- Whether there’s any other potential reason for your symptoms
- Whether your symptoms have changed at all over time (for instance, whether they’ve worsened, gotten better or come and gone)
- How your symptoms affect your life
- Whether anything relieves your symptoms
Your doctor will also perform a thorough physical examination, focusing on the area of your body where they believe that giant cell arteritis has developed. For example, if they suspect that you have temporal arteritis, they’ll likely examine your temporal arteries to determine whether they’re tender, cordlike or have a weakened pulse.
Your physician may also order one or more of the following diagnostic tests to determine whether you have giant cell arteritis:
- Biopsy
- Blood test
- Magnetic resonance angiogram (MRA)
- Positron emission tomography (PET) scan
- Ultrasound
How Do You Treat Giant Cell Arteritis?
The recommended course of treatment for giant cell arteritis can vary from one patient to another. With that said, this condition is most commonly treated with corticosteroids, a type of medication that’s designed to target inflammation. Many people with giant cell arteritis continue taking corticosteroids for at least a year, although their physician might lower the dosage over time.
Many individuals start feeling better within just days after beginning treatment for giant cell arteritis. However, it’s still possible to relapse even with treatment, so it’s important to continue monitoring your symptoms, following your doctor’s instructions and attending all recommended follow-up appointments. Please also note that any vision loss that occurs before taking corticosteroids is unlikely to resolve, which is why it’s so important to promptly seek treatment for a suspected case of giant cell arteritis.
What Are the Complications & Long-Term Effects of Giant Cell Arteritis?
Failing to treat giant cell arteritis can lead to serious complications such as:
- Blindness – Because giant cell arteritis can reduce blood flow to the eyes, it often causes vision problems. In some cases, it can lead to permanent vision loss. Blindness usually occurs suddenly and without pain, and it most commonly affects only one eye (although in some instances, vision loss can occur in both eyes).
- Aortic aneurysms – When the walls of a blood vessel weaken, they can bulge outward, producing what’s known as an aneurysm. Aneurysms are dangerous because they can burst, potentially resulting in life-threatening internal bleeding. Even if an aneurysm doesn’t burst, it still has the potential to cause a blood clot that blocks blood flow within the affected blood vessel. In some cases, giant cell arteritis produces aortic aneurysms, which affect the large artery carrying blood from the heart to the rest of the body.
- Strokes – Although rare, giant cell arteritis can sometimes lead to a stroke. This life-threatening condition occurs when parts of the brain don’t receive enough blood, often due to either a blocked artery or bleeding within the brain. Insufficient blood flow causes the cells in the affected areas of the brain to begin dying.
How Do You Prevent & Reduce Your Risk of Giant Cell Arteritis?
Because researchers have not yet determined what causes giant cell arteritis, at this point there’s nothing you can do to prevent this condition from developing. Plus, many of the risk factors for giant cell arteritis are unavoidable (e.g., age, sex and genetics). However, because studies suggest that living through stressful events could potentially increase your risk of developing giant cell arteritis, you should take steps to manage your stress levels: identifying and eliminating stressors that are within your control, prioritizing healthy lifestyle habits while deprioritizing harmful ones and making time in your schedule to relax are all ways you can manage your stress levels.
Living With Giant Cell Arteritis
Despite the many benefits that corticosteroids offer for individuals with giant cell arteritis, they can also lead to serious side effects including hypertension (high blood pressure), infections, muscle weakness and osteoporosis. To minimize your risk of side effects and manage your condition overall, your doctor may recommend that you:
- Take additional medications such as calcium and vitamin D supplements
- Eat a nutritious diet rich in fruits, vegetables, whole grains and lean meats and fish
- Limit your intake of alcohol, salt and sugar
- Exercise on a regular basis
- Sleep at least seven hours each night
- Take steps to avoid getting sick (e.g., regularly washing your hands)
- Quit smoking (if applicable)
Giant Cell Arteritis Frequently Asked Questions (FAQs)
If you have any reason to suspect that you might have giant cell arteritis, you should consult with a medical provider as soon as possible. Your physician will be able to answer any questions you might have about the condition. But in the meantime, here are answers to some of the questions we commonly receive about giant cell arteritis.
What’s the Life Expectancy for Someone With Giant Cell Arteritis?
When giant cell arteritis is promptly treated, it likely won’t affect a person’s life expectancy. In fact, when someone with giant cell arteritis receives swift treatment for the condition, their symptoms often start improving within days. However, failing to promptly treat giant cell arteritis can lead to potentially life-threatening complications like aortic aneurysms and strokes.
What’s the Difference Between Giant Cell Arteritis & Polymyalgia Rheumatica?
Because there’s such an overlap between individuals who experience giant cell arteritis and those who have polymyalgia rheumatica, some people might confuse the two conditions. Although both conditions produce inflammation, they’re not the same, and it’s important to distinguish between the two.
Giant cell arteritis causes inflammation in the lining of arteries and most commonly in the temporal arteries. Polymyalgia rheumatica, however, is an inflammatory disorder that primarily affects the neck, shoulders and hips. The symptoms of polymyalgia rheumatica generally affect both sides of the body and may include:
- Pain
- Achiness
- Stiffness
- Limited range of motion
- Fever
- Fatigue
- Reduced appetite
- Unexplained weight loss
- Depression
- Malaise (an overall feeling of being unwell)
Notably, polymyalgia rheumatica is considerably more common than giant cell arteritis—even though giant cell arteritis is one of the most common vascular disorders, it’s still relatively rare.
What Can Be Mistaken for Giant Cell Arteritis?
Because giant cell arteritis and pituitary apoplexy can produce many of the same symptoms—including a headache, vision problems, fever and fatigue—these two conditions can sometimes be mistaken for one another. Unlike giant cell arteritis, pituitary apoplexy occurs when the pituitary gland—a structure in the brain that creates, stores and releases hormones—has a blockage in blood flow or a hemorrhage (bleeding). An experienced medical provider will be able to distinguish between these two conditions, rule out any other similar conditions and recommend a treatment approach that’s customized to your specific needs.
Are There Any Alternatives to Oral Corticosteroids for Giant Cell Arteritis?
Oral corticosteroids continue to be the primary course of treatment for giant cell arteritis. However, in 2017, the U.S. Food and Drug Administration (FDA) approved the biologic medication tocilizumab for use in treating giant cell arteritis. Unlike corticosteroids that are taken by mouth, tocilizumab is administered either intravenously (through an IV) or as an injection. Your doctor can tell you whether you’re a candidate for tocilizumab.
The TGH Difference for Giant Cell Arteritis
It’s important to promptly seek treatment for giant cell arteritis because failing to treat the condition can lead to complications like blindness, aortic aneurysms and strokes. Fortunately, Tampa General Hospital’s esteemed Heart & Vascular Institute and Vascular Center of Excellence make it easy for members of the Tampa Bay community to receive the care they need.
With experience diagnosing and treating a wide range of conditions affecting the cardiac and vascular systems, our multidisciplinary team will provide you with highly individualized care. Depending on your specific needs, you may work with board-certified vascular and cardiac surgeons, general cardiologists, interventional cardiologists, heart failure specialists, electrophysiologists, radiologists, specialized cardiac and vascular care nurses and technologists. Our partnership with the University of South Florida also allows us to pursue advanced research and participate in innovative clinical trials. We’re proud to have been recognized by industry leaders such as:
- Becker’s Hospital Review – We’re the only hospital in the Tampa Bay region to have been included us on its list of 100 Hospitals and Health Systems with Great Heart Programs.
- Newsweek – We were ranked as one of America’s Best Specialized Hospitals for Cardiac Care in 2024.
- U.S. News & World Report – We were named one of the Nation's Best Hospitals for Heart & Vascular Care and a High Performing Hospital for Heart Attack and Heart Failure Treatment for 2024-25.
To learn more about how Tampa General Hospital’s Heart & Vascular Institute and Vascular Center of Excellence diagnose and treat giant cell arteritis, contact us today at (813) 844-3900 or email us at heart-vascular@tgh.org. We’ll also be happy to provide you with a referral to our hospital, which is conveniently located in Tampa, Florida.