Giant cell arteritis (Horton's disease)

Giant cell arteritis (GCA), also known as Horton's disease, is a chronic inflammatory disease of the large arteries, especially the temporal arteries, which supply blood to the head and neck. It occurs most often in adults over the age of 50 and is more common in women than in men.


The etiopathogenesis of giant cell arteritis is not completely known, but it is believed that there is a genetic component and that it may also be related to exposure to certain viruses and bacteria. The body's immune system appears to be involved in the inflammation of the arteries, which causes a narrowing or blockage of blood flow.


Symptoms of giant cell arteritis may include persistent headache, pain in the jaw when chewing, blurred or double vision, partial or complete loss of vision, fatigue, and fever. Diagnosis is based on a combination of clinical findings, such as the patient's age, the presentation of characteristic symptoms and the detection of inflammation in the blood, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and a biopsy of a temporal artery showing signs of inflammation.


Treatment of giant cell arteritis is based on early administration of corticosteroids, which reduce inflammation in the arteries and prevent possible serious complications, such as loss of vision. Treatment is started at high doses and gradually reduced over several months. Patients may require long-term treatment with a lower dose of corticosteroids to prevent recurrence of the disease. Other immunosuppressive drugs, such as methotrexate or tocilizumab, are also used. Tocilizumab is a monoclonal antibody that targets the interleukin-6 (IL-6) receptor that has been used in the treatment of giant cell arteritis in some patients who do not tolerate or do not respond adequately to glucocorticoids. In clinical studies, tocilizumab has been shown to be effective in reducing inflammation and disease symptoms, and may allow a more rapid reduction in glucocorticoid dosage. However, it should be noted that its use may be associated with some adverse effects such as infections.