Giant-cell arteritis - Polymyalgia rheumatica

The following article describes the definition and the synonyms, as well as the history, pathogenesis, prevalence and incidence of the temporal arteritis, also known as polymyalgia rheumatica, which is a T-cell-me dieted autoimmunvasculitis. The cardinal symptoms are severe headache, pain in the nape of the neck, impairment of vision, neurological deficits, psychiatric disorders and damages to various organs as a result of the ischemia due to the inflammation of the nutrient vessel. This inflammation mainly occurs in the supraaortal arteries but on a much less frequent basis also in arteries in other regions. The occult giant-cell arteritis, which manifests itself with a variety of unspecified symptoms con be mistaken as a malignancy and often remains unrecognised. The crucial diagnostic step is a biopsy from the temporal artery, but it should be emphasized that a negative result does not exclude the diagnosis of a temporal arteritis. Treatment with steroids is indispensable to achieve relief of pain and symptoms and to avoid vascular obliteration. The steroids should be given in a descending dosage over a sufficiently long period of time, taking into account the steroid-associated morbidity. Suggestions ore made in case of a resistance to this treatment.