L’Arterite a cellule giganti (GCA) è una malattia dei vasi sanguigni che può manifestarsi insieme alla polimialgia reumatica. Tale condizione si verifica in genere nelle persone anziane o comunque con più di 50 anni: può provocare gonfiore e ispessimento della piccola arteria temporale. Un mal di testa improvviso o uno persistente è un sintomo comune di GCA. Se colpisce il flusso di sangue agli occhi può mettere a rischio la vista. Si inserisce in un gruppo di malattie (vasculiti o arteriti) caratterizzate da infiammazione dei vasi sanguigni, ma coinvolge essenzialmente le arterie del cuoio capelluto e della testa, in particolare le arterie sopra le tempie, ed è per questo che tale patologia è nota anche come ” arterite temporale . ”
Sintomi
Il sintomo più comune (quello che si sente) è il mal di testa, di solito intorno alle tempie, ma può verificarsi ovunque, compresa la parte anteriore, superiore e posteriore del cranio. Ovvero in prossimità di tutto il cuoio capelluto. A questo si abbinano sintomi più generali come affaticamento, perdita di appetito, perdita di peso o una sensazione simil-influenzali. Ci può essere dolore alla mascella durante la masticazione. A volte l’unico segno di questa malattia è una febbre inspiegabile. Sintomi meno comuni includono dolori al viso, della lingua o della gola.
Se l’arterite a grandi cellule arriva a olpire gli occhi, è possibile che ne sia influenzata negativamente la vista: offuscamento temporaneo, visione doppia o cecità. Anche la perdita permanente della vista può verificarsi, ma tale eventualità è scongiurata dalla corretta terapia che è possibile. E’ importante in tal senso una diagnosi precoce.
Diagnosi di Arterite a cellule giganti (o arterite temporale)
Non esiste un semplice esame del sangue o un modo non invasivo per confermare la diagnosi di tale patologia reumatica. Il tasso di sedimentazione eritrocitaria (o tasso sed) è un esame del sangue che misura l’infiammazione: è alto nella maggior parte delle persone con GCA. Poiché altre malattie possono causare alti tassi di sedimentazione, i medici non possono fare affidamento su tale esame per una diagnosi certa. Solitamente si fa una biopsia -asportazione chirurgica di una piccola parte di arteria temporale (si fa in anestesia locale a livello ambulatoriale).
Terapia
Il trattamento per l’arterite temporale deve iniziare appena possibile a causa del rischio di perdita della vista. A differenza del trattamento per la polimialgia reumatica (PMR), che richiede solo corticosteroidi a basso dosaggio (chiamato anche glucocorticoidi), in questo casoo si utilizzano alte dosi. Tipicamente, la dose è di 40-60 milligrammi (mg) al giorno di prednisone (Deltasone, Orasone, ecc). Il mal di testa e gli altri sintomi diminuiscono rapidamente con il trattamento, e la velocità di sedimentazione declina ad un range di normalità.La terapia si fa per almeno un mese e poi gradualmente si riduce il dosaggio. Nella maggior parte dei casi, questo avviene in alcuni mesi, anche un anno. Raramente la malattia torna dopo la cura. Questi farmaci possono avere effetti collaterali importanti, per cui la cura può essere abbinata ad integratori e medicinali per preservare la salute delle ossa. Gli altri effetti (nervosismo, aumento di peso, insonnia) sono reversibili.
Leggi anche:
Artrite bambini, tutti i sintomi e i tipi
Fonte: Reumatology.org
Foto: Thinkstock
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