GCA and TIA

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Ardern
3

Hi Guys having been here for sometime. I will try to keep this as short possible. I was diagnosed with GCA Nov 2015 put on pred at 60 mg. I was able to taper back faster than doc recommended in 18 months. Been of pred since april 5 2017. I had no flare ups or symptoms. I have back cycling again do 60 - 70 k a day. Last Sunday woke up with what i felt was a stroke went to emerg. they did blood work ekg ct scan they new i had GCA. I seemed recover in a couple of hours was able to walk talk etc there did not seem to be any lasting effects. they said i had a neurological disorder. Tuesday the same thing i was in walking distance to a hospital. Emerg. treated in as a Stoke in progress again the same work up as on Sunday this time it was a TIA I need to treat it as a minor stroke. In both cases my sed Cr portein were normal all my blood chem was normal no marks indicating a stroke

Has anyone else had a similar event happen to them and was it relate to GCA and how did you deal with it

Thanks

Ardern

 

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  • Posted

    Not had anything like that - but if you have GCA and inflammation it narrows the arteries and increases the risk of TIAs and stroke, especially in the first year after diagnosis according to some studies - but not others.

    It isn't clear how much residual damage to the lining of the arteries there is after healed GCA but it is said there is increased atherosclerosis due to the use of pred. Repeated TIAs (symptoms resolve in under 24 hours) are regarded as a sign that there will be a major event in the foreseeable future and that preventative action may be indicated.

    Have your medics said they will do anything?

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    • Posted

      I had to be persistent they have an appointment for next Wednesday at a stroke rehab center so i am not sure what they are going to come up with. They are interested in my GCA history and at some point there should be a booking with a MRI I have already signed the waive.

      Do you know if the pred damage is permanent or is it possible for healing to take place if given enough time

       

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    • Posted

      I imagine that once atherosclerotic plaques form they persist. I know some doctors think we should be on statins to reduce that risk - my cardiologist has mentioned it to my GP in a letter having forgotten to say to me at the appointment! Really - no! I had a horrendous response to the statin I was given 6 years or so ago - it was worse than PMR, I really thought I was dying.

      The follow-up at the stroke unit will be to do all the appropriate screening - including carotids if they haven't already done that to see if there is any blockage there, it is the most common place. At least they have that planned at an early date. I was referred for one but the referral was inappropriate as what I had was a TGA (transient global amnesia) and not a TIA and there was absolutely nothing to suggest it was. A dope of an admitting physician to blame for that. So I didn't find out what they do - other than I had had a carotid scan, MRI and echocardiograph while in hospital.

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    • Posted

      I had the same experience with Statin..and yes, more pain that PMR!  I do take something call Zetia. It’s attractive because it’s one of the only non-statin options for lowering cholesterol and does not cause muscle pain or elevation of liver function tests.  On the otherhand I don't know much more. My Cardiologist recommended it for me and I am thankful.  

      As always, our bodies are so different..

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    • Posted

      Hi thanks for responding back in June in regards to a possible stroke or TIA.

      it’s now been 28 days since I texted you. Here is where I am today.  Probably ½ dozen blood test all normal sed rate below 2, c reactive protein between .3 and .5 all other blood chemistry normal. 2 CT scan normal, MRI and MRA normal except for some age relate problems associated with the brain. Echo Doppler cardiogram should only slight build up of calcified plaque in the carotid artery. My Doctor has prescribe 30 mg of prednisone daily. I was reluctant to start on that regiment again got result from a Doppler ultra sound of my temporal arteries today, indicating some form inflation in them on the right side. So tomorrow I am thinking of starting back at 20 mg  or do you think it would be better to hit it hard with 30 mg. I will not be seeing him until mid August.  I have no other symptoms no head ache, jaw pain, vision issues. Just some feeling problems below my left eye since the TIA.

      Thanks

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    • Posted

      If they have seen evidence of inflammation in the temporal arteries then I would be inclined to stay at 30mg a bit longer. Nor would I drop directly to 20mg when you do start reducing - 2.5mg at a time is quite enough. The blood markers being normal range doesn't mean a lot - 1 in 5 patients with PMR/GCA have no raised markers, and you are on pred, that SHOULD be bringing any raised levels back to normal.

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    • Posted

      Your right back in 2015 when I first was diagnosed with GCA my  SED rate was never elevated and the C reactive protein did not increase for a number of days after I started with prednisone. I check my schedule on the tapering i used back in 2016 and it was 2.5 mg a week as i crossed 30 mg. I will need to get in touch with my Doc sometime next week and see what he suggests. I have blood work schedule for Friday i hope everything is going to be normal. I can deal with that. Thanks again for your input

      Ardern 

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    • Posted

      I'm on Ezetimibe(Zetia) because I couldn't tolerate statins (nothing to do with PMR GCA though), have been taking it for 5 years.

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  • Posted

    I had/have GCA;  Three years ago I was having headaches. eye pain, scalp tenderness, jaw aches, etc. Dr decided to do an MRI just to make sure something else was not going on (Like a tumor, etc) The MRI revealed a minor stroke or TIA. Rheumatologist sent me to a Neurologist who thought I was doing fine, balance, etc.  I returned to my home in SW and cardiologist insisted on another MRI which came up with evidence of firts stroke, healed and nothing else.

    Actually a stroke is my greatest fear.  I am on 3.5 of Prednisone and can't seem to go below 3--big flair when I did 1 year and 1/2 ago. So, One of my Drs--the Rheumatologist in AZ said just keep on 3 mg.

    I am also taking an antiviral daily.  The virological and pathological findings followed by successful antiviral treatment support earlier notions that GCA and Takayasu arteritis may represent a spectrum of the same disease produced by varicella-zoster virus (VZV).  This treatment is not a proven one but  my Dr. and I chose to try it as the antiviral does not harm me and is often used for people with Herpes, etc.

    I am taking a baby aspirin a day.

    I wish you the best of luck

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