Causes, Symptoms and Treatment of Horton's Disease

1 Features of the disease

Pathology has many names. It is observed only in the elderly. This disease can be met quite rarely. Approximately 25 cases per one hundred thousand people. However, in people of the age category over 80 years old it is much more common. In addition to the fact that the temporal regions are affected, the process may involve the ocular arteries and there is a possibility of developing rheumatic polymyalgia. Horton's disease can also affect facial arteries, which mainly affects the area of ​​the jaw.

Pathology is characterized by its segmental nature of the lesion. Regardless of the fact that the arterial basin is mostly covered, the main changes can be observed in large vessels that move away from the aorta.

After the onset of the disease begins to form giant cells and granulomas. As a result, thickening of the vessel wall occurs, which contributes to the narrowing of the lumen.

2 Forms of development

Horton's disease is divided into three forms:

• Inflammatory. A pronounced manifestation of such symptoms as fever, severe headache, weight loss.
• Generalized. Pathology can affect not only women, but also men. This form is notable for the fact that there are no age restrictions for it. The ailment can develop both in the elderly and in young people. The headache worries much less often than with other forms.
• Atypical. Refers to the most dangerous. Pathology at the developmental stage is practically not accompanied by any signs until the development of the chronic stage begins. The danger is that it is difficult to determine it in a timely manner. In some cases, the syndrome of "sudden death" is possible. The only sign that can accompany the disease at the initial stage is frequent headaches. But, by and large the patient simply ignores it.

3 Risk Factors

In most people, the risk of disease is above all in people over fifty years old. Geneticity also plays an important role at the gene level. More often, people living in the northern part of Europe suffer from pathology.

There are other risk factors for the development of the disease.they include:

• localized headaches, migraine, which was not previously seen;
• erythrocyte sedimentation is above normal;
• increased or decreased pulse in the temporal artery.

4 Etiology of the manifestation of

There are a number of theories explaining why symptoms of temporal arteritis can manifest. Among the main ones is a hereditary predisposition. Other scientists argue that, since Horton's disease is observed only in elderly people, some connection with changes arising with age and hormonal changes is revealed. Women in menopause are twice as prone to pathology as men. In addition, the causes associated with the transfer of some infectious diseases are highlighted:

• herpes;
• of hepatitis B;
• adenovirus;
• flu.

As a result of studies of biopsies of artery walls, in almost all cases it is possible to detect immune complexes.

Given all of this, Horton's disease can be attributed to an autoimmune group of pathologies.

5 General Symptoms of

At the initial stage of development, temporal arteritis may not show any signs. On the other hand, if an infectious disease has been transferred before, the pathology develops in an acute form, which is explained by a decrease in immunity.

In the beginning, the disease will have symptoms similar to SARS: headache, fatigue, fever. A little later, active weight loss begins, including anorexia, arthralgia, insomnia.

As the development of Horton's disease can acquire a vascular symptomatology:

• increased density of the temporal arteries with a sensation of pain when touching them;
• nodules on the scalp;
• swelling and congestion on the temples.

When the internal carotid artery is injured, a stroke and ischemic attack are possible.

In addition, during the disease can be affected by the organs of vision. In this case, the following is observed:

• diplopia;
• view blurredness;
• pain syndrome;
• blurring of objects.

More symptomatic is associated with vascular lesions and impaired blood supply to eyeballs. If you do not seek medical help in a timely manner, if there are any such symptoms, you may lose sight completely.

6 Diagnostic methods

To make the correct diagnosis, you must visit a therapist or an angiosurgeon. The doctor will have an anamnesis and taken into account family cases of pathology. Despite the fact that the clinical picture has a characteristic symptomatology, it must be differentiated with other pathologies of vascular risk. For this purpose, additional types of examination can be prescribed:

• consultation with a neurologist and an ophthalmologist;
• biopsy of the temporal artery;
• ultrasound;
• CT and MRI of the brain with contrast;
• biochemical blood test.

The diagnosis is based on the presence of at least three of the following diagnostic criteria:

• old age;
• leukocytosis;
• headache;
• accelerated ESR;
• elevated C-reactive protein;
• dysproteinemia;
• marked changes in scalp.

For a definitive confirmation or refutation of pathology, biopsy of the temporal artery is performed. Only with it can you determine the thickening in the walls of the vessels, the presence of granulomas and the formation of blood clots.

In the case when the entire clinical picture is present, and biopsy shows negative results, we can speak of segmental lesions of the arteries.

7 Directions of therapy

The best efficacy in treatment is achieved with the use of glucocorticosteroids, which since the onset of the disease are prescribed in large doses.

Prednisolone is often prescribed. Dosage should be gradually reduced with an adjustment of three days.

Intensive therapy can last in different ways. If intraocular complications have a severe form, pulse-therapy is performed, at which significant doses of methylprednisolone are prescribed. To maintain therapy in small doses, it is recommended to take Prednisolone within one to two years.

In addition, other medications may also be prescribed:

• angioprotectors;
• heparins;
• antimalarial drugs;
• anticoagulants.

Extracorporeal hemocorrection is performed to remove immune complexes from the body, which provoke inflammatory reactions. If a person of advanced age has diabetes mellitus, antibiotic therapy is always prescribed.

If we talk about traditional methods of treatment, then specialists do not recommend replacing them with conservative therapy. This is explained by the fact that in the absence of timely use of hormonal means, the probability of complications is high.

8 Possible complications of

If untimely treatment of a disease is likely, pathology can trigger the development of a variety of complications. Among the main ones are:

• blindness;
• Diplomacy;
• visual hallucinations;
• anterior and posterior ischemic neuropathy of the optic nerve;
• amblyopia.

The most serious consequences are blindness and heart attack.

With the timely adoption of measures, it is likely that pathology can be eliminated, and there will be no complications. If the disease is at a neglected stage, deterioration occurs, other important arteries can be affected simultaneously with the temporal.

To prevent this from happening, it is necessary to timely eliminate infections of an infectious nature, take care of strengthening immunity, and if the first signs are displayed, do not postpone medical treatment.