Polymyalgia Rheumatica (PMR) and Giant Cell Arteritis (GCA)
What is giant cell arteritis (GCA) and polymyalgia rheumatica (PMR)?
Giant cell arteritis causes inflammation that damages the arteries (blood vessels that carry blood and nutrients from the heart to tissues in the body). The large- and medium-sized arteries are affected.
Because some of the affected arteries provide blood to the head (cranium), including the temples, the condition may also be called cranial or temporal arteritis.
Polymyalgia literally means "many muscle pains." Rheumatica means "changing" or "in flux."
Who is affected by PMR and GCA?
Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) frequently affect the same types of people. The diseases may occur independently or in the same patient, either together or at different times.
People over 50 years old are typically affected with PMR and GCA. The average age of patients is 74. One-third of patients with GCA also have PMR.
Both diseases are two to three times more common in women than men, and there is a higher incidence among Caucasians than any other ethnic group.
Can other problems be confused with PMR?
Other illnesses that may be confused with PMR include:
- Rheumatoid arthritis
- Inflammation of blood vessels (vasculitis)
- Metabolic (chemical and hormone) abnormalities
- A variety of muscle diseases
- Cancer and many other diseases
What causes polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) ?
The exact cause of these illnesses is unknown.
What are the symptoms of GCA? How often do they occur?
- Atypical severe headaches are the most common symptom and occur in over 80% of patients.
- Scalp tenderness, fatigue, fevers and a general sense of illness occurs in about 50% of patients.
- Jaw or facial soreness, especially with chewing, also occurs in about 50% of patients.
- Vision changes or distorted vision caused by decreased blood flow occur in 15 to 50% of patients; blindness occurs in 5 to 15%.
- Stroke may occur in less than 5% of patients and is caused by decreased blood flow to the brain.
- The large blood vessels may become narrowed or enlarged (aneurysm); see figure. If narrowing occurs in the blood vessels leading to the arms or legs, patients may notice fatigue or aching in the limbs because of a reduced blood supply. Weak or absent pulses may be noticed by the doctor. These symptoms occur in 15 to 20% of patients.
A blood vessel can become inflamed and narrowed, or segments of a blood vessel can weaken and stretch (aneurysm). When aneurysms occur, they are usually present in the aorta, the body’s largest vessel that carries blood from the heart. When blood vessels become narrowed, there is restricted blood flow. If the blood vessel is completely blocked (occluded), there is no blood flow through that segment.
What are the symptoms of PMR?
Pain or aching is usually felt in the large muscle groups, especially around the shoulders and hips.
Other symptoms may include:
- Stiffness, especially in the morning and after resting
- Generally feeling ill
- Mild fevers (occasionally)
- Weight loss