Temporal arteritis: how to identify and how to treat?

When the blood circulates normally, acceptable conditions are created for the good functioning of all organs. With the help of blood, tissues receive the necessary nutrients and oxygen, from the body are derived decay products and carbon dioxide. Any violation in the circulatory system is dangerous because the vessels are damaged, and a deficiency of nutrients and the accumulation of food residues cause diseases of the internal organs.Temporal arteritis is a consequence of circulatory disorders. This disease is dangerous to human health.

What it is?

Temporal arteritis (Horton's syndrome or giant cell arteritis) is a systemic disease characterized by the defeat of large and medium arteries located within the carotid artery.

The vessels most often affected are those that supply blood to the eye, parts of the head and optic nerves.

In this pathological process, any large or medium artery can be involved.In this case, in smaller vessels, no changes are observed.

The disease is manifested by swelling and pain in the area of ​​the temple and the scalp. It is mainly diagnosed in people (mostly in women) of advanced age (over 60 years).

Causes

When Horton syndrome occurs, the arterial walls become inflamed, become edematous, the lumen between them narrows.As a result, it is difficult to transport blood, slowing the delivery of oxygen and nutrients.If the disease is not diagnosed on time and immediately does not begin treatment, then a blood clot is formed, which completely closes the vessel.Another danger - an aneurysm (protrusion of the vessel wall), which after a while may burst.

The reasons for the development of temporal arteritis have been poorly studied. It has been proved that the process of vascular aging and destruction of their walls plays a significant role in the onset of the disease.That is why arteritis is typical for the elderly (60-80 years). More often, the disease occurs in women, as well as in people of white race and identical twins.Researchers argue that arteritis can be transmitted at the genetic level.

Some scientists also hypothesize that arteritis is associated with infections. However, this version does not have any weighty evidence.

It is possible that the emergence of temporal arteritis is facilitated by environmental factors.There are many cases when arteritis accompanies rheumatic polymyalgia.This disease is characterized by painful symptoms, which manifest themselves in different muscle groups and have a rheumatic character.

One of the signs of arteritis is a constant headache

Isolate the primary and secondary form of arteritis.

1. Primary form - vasculitis - arises as an independent disease in people of advanced age.
2. Secondary arteritis is a consequence of another disease of an infectious nature. Especially dangerous are infections caused by golden staphylococcus and hepatitis virus.

Inside view: arteritis and healthy artery

Symptoms

Usually, temporal arteritis begins with an acute headache, and unpleasant painful sensations intensify when combing the hair or touching the head with your fingers. The general state of health worsens, the temperature rises.Patients experience pain in the lower jaw joint during chewing, in the neck and arms, complain of poor appetite. If the disease is a companion of rheumatic polymyalgia, symptoms such as pain in the muscles of the shoulder girdle and pelvic region are added to the general clinic.

The vessels of the temporal and adjacent areas are compacted, slightly protruding and take a twisty shape. The skin over them is often hyperemic. With the defeat of the nerve trunks involved in the innervation of the eye, symptoms are manifested in the form of bifurcation and clouding in the eyes, sudden blindness, lowering of the upper eyelid.

Diagnostics

When observing the above symptoms, it is necessary to consult a rheumatologist for immediate diagnosis of the disease.The examination includes general examination of the patient, collection of anamnesis and necessarily referral to a blood test (general and biochemical).Only the results of a blood test make it possible to make a preliminary diagnosis. The final diagnosis can be made only after receiving the results of a biopsy.

When analyzing blood, the main are two parameters:

• ESR (sedimentation rate of erythrocytes);
• C-reactive protein.

In the presence of inflammatory processes in the arteries, both indicators will have inflated values.

At laboratory research of the general or common analysis of a blood the too increased speed of subsidence erythrocytes (up to 50-70 mm / h), as well as a reduced level of erythrocytes in normal color indicator.In this case, the leukocyte formula remains unchanged.

After receiving the results of a blood test, a biopsy is assigned to the patient, which involves examining a small fragment of the temporal artery under the microscope. Carrying out of the given analysis at suspicion on a temporal arteritis is of decisive importance.A biopsy can accurately identify or exclude arteritis. After all, a similar symptom can be a sign of another disease: rheumatic polymyalgia, arthritis or cancer.

Most often this disease is observed in the elderly

Treatment

Provided that the patient's early treatment to the doctor, timely diagnosis and therapy, temporal arteritis is amenable to treatment with a favorable outcome. EIf a person has already turned on in the late stages or the arteritis is aggravated by some serious pathology, the treatment can be complicated. An unfavorable outcome with subsequent disability is quite possible.

Treatment of temporal arteritis can be carried out by two methods: medicamentous and surgical.

Medication

Therapeutic treatment option involves the appointment of high doses of strong anti-inflammatory drugs - glucocorticosteroid hormones.Often medicines are prescribed before the diagnosis is finally confirmed, since the time in this case works against the patient, and delay can lead to serious consequences. Early treatment is especially important when there are symptoms at the level of vision.Even with the slightest suspicion of arteritis, the patient should be prescribed corticosteroid hormones.

The course of treatment for Horton's syndrome is very long and usually takes from one to two years. During this period, the dose of medications will gradually decrease.

The first dose reduction occurs within a month after the start of the course of treatment.Glucocorticosteroids have many side effects:

• increased blood pressure;
• increased blood glucose;
• weakening of immunity;
• increase in body weight;
• probability of osteoporosis.

But for today it is the only medication method that can effectively cure arteritis.

If the patient has an intolerance to corticosteroids, the doctor must prescribe other drugs. In this case, the success of treatment is reduced at times.

When arteritis prescribed drugs that improve blood flow and prevent the formation of blood clots. During the treatment period, the patient must regularly take tests so that doctors can monitor the course of the disease and prevent a possible relapse.If the symptoms began to return to the baseline, then the dose reduction was prescribed too soon, and the patient should again increase the dose of medication.The extinction of the initial symptoms, the normalization of the level of indicators in the blood (hemoglobin and ESR) will be indicative of the retreat of the disease.

Symptomatic relapse usually occurs in patients a few days after the start of taking corticosteroids. Improved and blood test: the level of ESR begins to drop to normal after a couple of weeks.Nevertheless, the course of taking medications must be completed completely, otherwise the arteritis will return quickly.

Patients with a threat of blindness are prescribed Prednisolone intravenously for three days, after which they are transferred to conventional treatment.If the temporal arteritis has affected the nerve trunks that affect the retina, the doctor prescribes the use of vasodilating and vasoconstrictive medications.

Simultaneously with glucocorticosteroids, a diet is prescribed, including the use of products containing calcium. This will help prevent the development of steroid osteoporosis.

Surgical treatment of arteritis

When the disease is started and takes a complicated form, the patient has a high risk of an aneurysm or a blood clot.In addition, the vessels that supply blood to the eyes are affected. In this case, the drug method is not suitable because of the length of the course of treatment.And here you can not do without surgical intervention.

The surgical method of treatment is also relevant, when the temporal arteritis is provoked by an oncological disease.

Complications

One of the most serious complications of arteritis is loss of vision.Blindness occurs as a result of disturbed blood flow through inflamed vessels to the eyeballs and optic nerves.Lack of appropriate medical measures leads to the fact that the nerve tissue of the retina and optic nerves are dying, resulting in complete blindness.

Prevention of disease

Primary prophylaxis of temporal arteritis is very difficult, since the exact cause of the development of the disease has not been established to date.Secondary prevention (prevention of exacerbation) is the lifelong administration of steroid hormones and immunosuppressants.

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How to determine if there is a viral or bacterial conjunctivitis in a child, you will learn in the article.

How to restore vision with hyperopia is described in detail here.

Treatment of macular degeneration of the retina: http://eyesdocs.ru/zabolevaniya/makulodistrofiya/makulyarnaya-distrofiya-setchatki-glaza.html

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conclusions

Temporal arteritis is a rather dangerous disease, which must be identified and treated at an early stage.In this case, the treatment prognosis will be favorable, and the consequences will not be very significant. You have already become acquainted with the clinical picture of this disease, so at the first symptoms immediately consult a rheumatologist. As a rule, in the absence of treatment of this disease, patients have paralysis of the optic nerve, which leads to such diseases as cataract and glaucoma or retinal dystrophy, what is it you will learn here.