Temporal arteritis treatment with steroids

AAION is characterized by acute monocular vision loss accompanied by optic disc edema. The optic disc edema in AAION is usually diffusely “chalk white”, and may be accompanied by disc hemorrhage, retinal whitening or cotton wool spots. [9] Adjacent retinal whitening and cotton wool spots are crucial findings that indicate concurrent retinal ischemia, and should raise a clinician’s suspicion for GCA. Visual acuity is often 20/200 or worse, with up to 21% demonstrating no light perception. [45] An obvious afferent pupillary defect is often present. Visual field loss in patients with AAION is typically in a central, arcuate, or altitudinal pattern.

My study has shown that determining the maintenance dose of steroid therapy is a slow, laborious, painstaking job, taking months or even years. The guiding principle, obviously, is to maintain the lowest level of ESR and CRP with the lowest dose of Prednisone . As mentioned above, my study showed marked inter-individual variation among GCA patients in: (a) the amount and duration of steroid required to control the active disease, (b) the time needed to reach a maintenance dose, (c) the maintenance dose required to keep the disease under control to prevent blindness, and (d) the total length of treatment. [4,5,7,8] Therefore, steroid therapy for GCA has to be individualized. I have found that most GCA patients require a virtually life-long, very small maintenance dose, which has little or no systemic side-effects. [7] A common mistake made by physicians in these cases is to taper the steroids down rapidly to a very low dosage and then discontinue it. There is a common belief among rheumatologists that GCA burns itself out in a year or two, and steroids can then be tapered off unless the patient develops systemic symptoms.[ 7,8] As discussed above, I have found this notion to be completely wrong, and can prove disastrous, because repeat temporal artery biopsy has shown evidence of active disease even after 9 years of steroid therapy.[ 7,8] The advice to base treatment on the clinical picture, rather than laboratory tests (. ESR and CRP) may be true for polymyalgia rheumatica patients. But it can be dangerous for patients with GCA, who may lose vision irrevocably without developing any warning systemic symptoms at all; moreover, 21% of patients with visual loss have occult GCA. I have found that the only trustworthy and safe parameters to regulate the steroid therapy and to prevent visual loss are the levels of ESR and CRP, and nothing else .[ 4,5,7]

Giant cell arteritis (GCA) is the most common of the systemic vasculitides [ 1 ]. GCA is also a classic systemic rheumatic disease of older adults; it virtually never occurs in individuals younger than 50 years of age and peaks in incidence in the seventh decade [ 2 ]. Although all ethnic groups can be affected, most patients with GCA are white [ 3 ]. Many of the symptoms and signs of GCA result from involvement of the cranial branches of arteries that originate from the aortic arch, but, as the disease is systemic, vascular involvement can be widespread.

Taking both a steroid and aspirin can greatly increase your risk of developing a stomach ulcer. If you take this combination of medicines it is commonly advised that you also take a medicine to reduce the acid in your stomach. The aim is to prevent the serious complication of a bleeding stomach ulcer from developing. PPIs  are a group (class) of medicines that work on the cells that line the stomach, reducing the production of acid. They include esomeprazole , lansoprazole , omeprazole , pantoprazole and rabeprazole . They come in various different brand names. One of these will normally be advised if you take a steroid and aspirin.

Temporal arteritis treatment with steroids

temporal arteritis treatment with steroids

Taking both a steroid and aspirin can greatly increase your risk of developing a stomach ulcer. If you take this combination of medicines it is commonly advised that you also take a medicine to reduce the acid in your stomach. The aim is to prevent the serious complication of a bleeding stomach ulcer from developing. PPIs  are a group (class) of medicines that work on the cells that line the stomach, reducing the production of acid. They include esomeprazole , lansoprazole , omeprazole , pantoprazole and rabeprazole . They come in various different brand names. One of these will normally be advised if you take a steroid and aspirin.

Media:

temporal arteritis treatment with steroidstemporal arteritis treatment with steroidstemporal arteritis treatment with steroidstemporal arteritis treatment with steroidstemporal arteritis treatment with steroids

http://buy-steroids.org