Gant cell Arteritis or Temporal Arteritis:-
Temporal (Giant Cell) Arteritis.This is a form of granulomatous inflammation of medium sized and large arteries.
Preferential sites of involvement are the cranial arteries, especially the temporal, and hence the name.
However, the aorta and other major arteries like common carotid, axillary, brachial, femoral and mesenteric arteries are also involved, and therefore, it is preferable to call the entity as ‘giant cell arteritis’.
The patients are generally over the age of 70 years with slight female preponderance.The usual clinical manifestations are headache and blindness if ophthalmic artery is involved.
An association with polymyalgia rheumatica has been observed. The cause of the condition remains unknown though there is suggestion of T-cell mediated immunologic reaction to some component of the arterial wall, especially against the damaged internal elastic lamina. Biopsy of the affected artery is not only of diagnostic value but also relieves the patient of painful symptoms.
Complications:-
-> Nocardia origin people more chance to suffer.
-> people suffer who are more than 40-50 year old.
-> It is chronic inflammatory disroder of large to small size arteries principally affect to head eg temporal arteries..
-> Chronic inflammatory disroder.
-> Rare before age 50 year.
-> Involve specially - Temporal arteries, Opthalmic arteries, Vertebral arteries.
-> Granulomatous inflammation in media of temporal artery.
Eg-If vasculitis in Temporal artery.
--: Mostly 70% patients have inflammation in elastic lamina. Inflammatory cells like- ( neutrophils, macrophage, eosinophils, langhans gaint cell, foreign body gaint cell).
- In 30% patients inflammatory cell present in media also.
-> In 50% patients of this disease which may have Polymyalgia Rheumatica ( pain in proximal muscle of gridlde).
Clinical features:-
• If temporal arteries then increase ESR , tendersness (pain), nodular arteries.
• If opthalmic arteries involve - blindness
Treatment - high dose steroids is nessasory.
• If axillary arteries - facial pain, jaw clodication ( pain in mucles when muscles are working their artery are fail to provide extra blood. Eg during masticating.
• If vasnervosum artery ( blood vessels which supply nerves) involve - Mononeuritis multiple.
Sign -
pain in combing especially temporal area ( due to shoulder girdle pain & pain in the wearing coat & sitting ).
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