Temporal Arteritis Treatment and Prevention

Though there is no known means of preventing or curing temporal arteritis, the disease typically runs a self-limited course over several months to several years. Early treatment is important for good results. When it is properly treated, temporal arteritis is not threatening in most patients. However, if left untreated it may lead to serious complications, such as blindness, stroke or an aortic aneurysm. In a small number of patients, these problems can develop even when temporal arteritis is diagnosed and treated.

The most common of these complications is impaired vision or blindness. To reduce this risk, patients are typically referred to an ophthalmologist to watch for any signs of threatening blindness, such as involvement of arteries that supply the eyes with blood.

The most commonly prescribed medications for temporal arteritis are oral corticosteroids. These medications are started immediately in high doses to prevent blindness. In some cases, corticosteroid therapy may be initiated before diagnosis is confirmed with a temporal artery biopsy.

Although patients usually begin feeling better in just a few day, they typically continue taking a high dose for one month. As symptoms disappear and the risk of blindness is removed, the dose is gradually reduced to the lowest effective dose. Dosage must be reduced gradually because these drugs alter the body’s natural production of certain hormones. Stopping the medication suddenly can make a person very sick.

Most people can stop taking corticosteroids in six months to two years, but treatment is occasionally prolonged beyond this. Possible side effects of long-term use of corticosteroids include osteoporosis, fractures, diabetes, glaucoma, cataracts and high blood pressure. All side effects should be reported to a physician. A physician may recommend that patients on corticosteroids take supplements of calcium and vitamin D to reduce the risk of osteoporosis. Recent research suggests that high-dose intravenous corticosteroid therapy for only a few days may resolve temporal arteritis or reduce long-term need for oral corticosteroids.

Although the symptoms of temporal arteritis respond well to proper medication and treatment nearly eliminates the risk of serious complications, patients may wish to take certain other factors into consideration:

* Exercise. Important to maintain joint flexibility and muscle strength and function. Exercise may be particularly useful in dealing with possible drug-induced side effects, such as increased glucose (blood sugar) and decreased bone density. Low-impact exercises (e.g., swimming, walking) and stretching are usually emphasized. Patients should consult their physician before starting an exercise program. It is important to start slowly and work up gradually, particularly if the patient is not used to regular exercise.

* Nutrition. May help prevent such potential problems as thinning bones, high blood pressure and diabetes, which are associated with corticosteroid use. Proper nutrition can also strengthen the immune system. Fresh fruits and vegetables, whole grains and lean meats and fish are emphasized, as well as foods with plenty of calcium and vitamin D. Salt, sugar and alcohol are limited. Tobacco should be avoided.

When properly treated, temporal arteritis seldom recurs.

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