Giant Cell Arteritis or Temporal Arteritis is an Autoimmune Disease

Autoimmune diseases are diseases in which the body's own immune system attacks its own tissue as if it were a foreign invader. Although not clearly understood as to the cause of such illnesses there is ongoing research for a common trigger. Viruses may play a role in the development of the disease as well as prolonged stress. Stress is something that we all have and it is very difficult to eliminate. Viruses are also very hard to avoid but vigilant hand washing is something that we can all do to avoid getting sick. Antibacterial gels are now available everywhere. They are very prominently located in hospitals and the public in encouraged to use them.

Recently, our family has learned first hand about one autoimmune disease in particular. My husband at the age of fifty-two has developed giant cell arteritis. It is also commonly referred to as temporal arteritis. One of the first symptoms he recalls is fatigue of an unusual nature. It was a slow decline in energy that went unnoticed for the most part by me. He chalked it up to stress and getting older. When he began to come home from work at night and hit the couch without eating I knew something was going on. He talked about pain at the back of his head that began to wrap around to the temple area. He very clearly explained that it was not a classic headache but pain to touch those areas. Frequently he began waking up at night because it hurt to lay his head on the pillow. Then he began having night sweats and weight loss. Finally, after about eight days of being ill I insisted on taking his temperature. He had a fever of 100.5 and at that I point I demanded we take a trip to the emergency room.

The E.R. doctor ran many blood tests. There are three tick borne illnesses that are very common to our area and those were focused on. Also, a C.T. scan of his head and a chest x-ray were ordered. Included in the tick panel was the customary complete blood count along with a sedimentation rate. The sedimentation rate is usually high in inflammatory conditions. What came back was a mildly elevated white count and a mildly elevated sedimentation rate. The doctor was not impressed and stated that my husband most likely was suffering from a viral illness. At the time I did question whether it was possible that my husband had temporal arteritis. He said most likely not because it was a disease of the elderly and occurred on only one side of the head. So, we were sent home with instructions to return to the E.R. in three days if his fever and illness continued. Unfortunately, my husbands primary doctor was on vacation and unavailable.

Three days later, all symptoms were persisting and a new one became apparent. He began to experience terrible leg pain at night as well as the night sweats. After a sweat he would shiver so violently that he felt it difficult to catch his breath. We returned to the E.R. and encountered a new doctor that repeated all of the same tests with the exception of the tick panel. We were informed that those tests came back negative. After many hours of waiting we learned that the white count was slightly more elevated as well as the sedimentation rate. In addition the chest xray had a opaque shading with some possible infiltrates. At this juncture the doctor said it would be best to admit my husband for further studies. Unfortunately, my husband has type 2 diabetes and his sugar was quite high.

At this point my husband spent four days in the hospital and endured a battery of tests. There were blood cultures drawn to see if his blood harbored a bacteria of some sort. He was given one intravenous dose of Ceftriaxone and one dose of Ci pro which are both very strong broad spectrum antibiotics. He continued to experience the fevers, the sweats and the horrible leg pain. All he did was sleep. The doctor had decided to put him on insulin injections to control his diabetes because his oral medication was not effective.

On the third day of his confinement a new doctor came to visit in the morning. He was there to discharge my husband as there were no bacteria found in his blood. I questioned how I was to take home a man that was so visibly and symptomatically sick when we had no diagnosis. As more blood had been drawn early that morning I asked if he had received any of those results. The doctor said he would check on it but he was pretty sure that this viral illness could be treated on an out patient basis. Before he left I asked if he thought there may be an autoimmune problem due to the fact that the sedimentation rate was high and the white count elevated. I specifically asked about the possibility of Temporal Arteritis. We were told that it was a rare illness and probably unlikely. He did however return thirty minutes later to inform us that there had been additional markers for an autoimmune illness that he had just discovered on the new blood work.

My husband got to stay an additional day in the hospital as a new medication was added. Prednisone is a steroid that is very powerful and effective at reducing systemic inflammation. It is associated with some serious side effects and it can increase blood sugar. For my husband who already has type 2 diabetes it is doing a number on him. The dose that helps him the most is dangerously shooting his blood sugar up into the four hundreds at times. Before discharge a nurse taught us how to test the sugar and inject insulin using a chart for dosing. My husband learned very quickly how to do everything. As sick as he is he vigilantly checks his sugar and injects insulin four times a day. He also uses a fifth injection of Lantus before bed which is a longer lasting type of insulin.

Since is release he has had to have a biopsy of the temporal artery. Also, he was referred to a rheumatologist that is a doctor that specializes in autoimmune diseases. The biopsy did come back with a negative finding but the rheumatologist did say that would be a possibility. Some of the inflammation can be patchy and not affect the whole artery but just portions of it. So, he was referred to Boston Medical Center and will be meeting with a top notch doctor in the vascular department. Thankfully, we live close enough to the best medical treatment one could ever hope for when faced with a serious illness.

I have begun to keep a detailed log of all of his appointments including any medication changes. The prednisone level was increased by the rheumatologist because he was still so symptomatic after he was released from the hospital. I did ask her about the steroids adverse affect on the diabetes control that my husband was experiencing. She said he did not have a choice and that he was basically stuck between a rock and a hard place. Last night for the first night in four weeks my husband slept straight through without the excruciating leg pain. He did have a sweat episode that briefly woke him but did not shiver uncontrollably and was able to drift back to sleep.

Although he has a long road ahead of him there is one thing I can count on. He has never stayed stuck between a rock and a hard place for very long whenever faced with a challenge. He is one of the smartest people I have ever known. Some people cower in that small dark space, some go over and some will go around. My man will chisel his way through that rock no matter how long it takes and he will come out the other side.