ARTERITIS

inflammation of the arteries. It may occur in any of a number of diseases, including syphilis; tuberculosis; disease of the pancreas; serum sickness, which is a reaction against a foreign protein; and lupus erythematosus, a systemic disease that has also been attributed to some form of immune reaction. Five varieties of arteritis not closely associated with systemic disease or disease of an organ outside the cardiovascular system have been described: thromboangiitis obliterans (see Buerger's disease); temporal, or cranial, arteritis; arteritis of the agedalso called senile arteritis and polymyalgia rheumatica; aortic arch arteritis (see aortic arch syndrome); and polyarteritis nodosa (q.v.). Temporal, or cranial, arteritis (also known as giant-cell arteritis), which involves inflammation of the temporal arteries and of other arteries in the cranial area, is of unknown cause, although it is usually preceded by an infection. Most persons affected are in their 50s or older. The disease usually starts with a headache, which may be accompanied by pain in the scalp, face, jaws, and eyes. The affected person may find it difficult to move his jaws because of deficiency of blood flow to the jaw muscles. Paralysis of the eye musclesophthalmoplegiamay cause the affected person to see double, a condition called diplopia. Fluid may collect in the retina and in the optic disk, the point at which the optic nerve enters the eyeball; this condition leads to vision loss in about 10 percent of those diagnosed. The disease may persist for as long as three years or may subside in a few months. The chief danger of temporal arteritis is its effect upon the eyes. Impairment of vision is combated by administration of an adrenocorticosteroid hormone (a hormone secreted by the adrenal gland or a synthetic substitute). The more common arteritis of the aged, which may be related to temporal arteritis, characteristically causes pain and wasting in the upper muscles of the limbs and in certain muscles of the neck. The condition usually develops rapidly, often after sensations of fatigue and loss of appetite. Adrenal steroids moderate the symptoms, but usually recovery occurs whether or not this medication is used.