🔅 PROGNOSIS OF GCA:

– The prognosis of GCA depends on the severity of the disease, the response to treatment, and the development of complications. Most people with GCA respond well to corticosteroid therapy and achieve remission within a few months. However, some people may experience relapses or flares of the disease, especially during the tapering of corticosteroids. Relapses may require an increase in the dose or duration of corticosteroid treatment.

GCA Complications

– The most serious complication of GCA is permanent vision loss, which can occur in up to 20% of untreated cases. Vision loss can be prevented by prompt diagnosis and treatment with high-dose corticosteroids.

– Other possible complications of GCA include:

• Aortic aneurysm: This is a bulge or weakening in the wall of the aorta, the main artery that carries blood from the heart to the rest of the body. Aortic aneurysms can rupture and cause life-threatening bleeding.

• Aortic dissection: This is a tear in the inner layer of the aorta, which allows blood to flow between the layers and separate them. Aortic dissection can cause severe chest or back pain and can lead to organ damage or death.

• Large artery stenosis: This is a narrowing or blockage of the large arteries that supply blood to the arms, legs, or other organs. Large artery stenosis can cause symptoms such as limb claudication (pain or cramping in the muscles with exercise), asymmetric blood pressures, abnormal pulses, vascular bruits (abnormal sounds heard over the arteries), or organ ischemia (reduced blood flow to an organ).

• Cardiovascular disease: This includes conditions such as coronary artery disease, heart attack, stroke, and peripheral artery disease. People with GCA have an increased risk of developing cardiovascular disease due to chronic inflammation and steroid use.

The difference between GCA and PMR

• GCA stands for giant cell arteritis, while PMR stands for polymyalgia rheumatica.

– GCA is a condition that causes inflammation of the large and medium-sized arteries in the head and neck, which can affect the blood supply to the eyes, scalp, face, and other organs.

– PMR is a condition that causes pain and stiffness of the muscles around the shoulders, neck, hips, and thighs.

– GCA and PMR are closely related and often affect the same types of people, especially older adults, women, and people of European descent. About half of the people with GCA also have PMR, and about 10% of those with PMR also have GCA.

– GCA and PMR may be manifestations of the same underlying disease and sometimes coexist.

Symptoms of GCA and PMR

– Some of the symptoms of GCA include severe headaches, scalp tenderness, jaw pain, vision problems, fever, fatigue, weight loss, and loss of appetite.

– Some of the symptoms of PMR include pain and stiffness in the shoulder and pelvic musculature, which may be worse in the mornings

Diagnosis of GCA and PMR

– The diagnosis of GCA is usually confirmed by a biopsy of the temporal artery (the artery that runs along the side of the head), which may show abnormally large cells called giant cells.

– The diagnosis of PMR is mainly based on the clinical features and blood tests that measure the level of inflammation in the body.

Treatment of GCA and PMR

– The main treatment for both GCA and PMR is high-dose corticosteroids, such as prednisone, which are effective in reducing inflammation and preventing complications. The treatment usually lasts for one to two years or longer until complete remission is achieved.

– The treatment may also include other medications to prevent or treat side effects of corticosteroids, such as blood clots, stomach ulcers, osteoporosis, infections, or diabetes.

– The prognosis for both GCA and PMR is good if treated promptly and properly.