Horton’s disease is a form of arteritis that occurs mostly in the elderly. It is a disease that is known by few people. Discover in this article the different symptoms, causes and adequate treatments to overcome this disease.
Table of contents
Horton’s disease, targets
HORTON’S DISEASE IS A DISEASE THAT RESULTS FROM AN INFLAMMATION OF THE WALLS OF THE TEMPORAL ARTERIES.
It is also a form of arteritis that affects all the vessels that carry blood from the heart to the organs. Even though the exact origin of Horton’s disease is not yet known, a few factors may contribute to its development.
There are many targets that are most vulnerable to contracting Horton’s disease. Among these targets are people in their fifties and older. Indeed, if you are over 50 years of age, the probability of contracting this disease is very high. Women are also easy prey to this disease. Similarly, people from Northern Europe and people who have Forestier-Certonciny syndrome are also targets of this disease.
Horton’s disease, the symptoms
Horton’s disease is often recognized by several factors:
- The flu: The very first symptom that often appears in a person with Horton’s disease is the flu. This flu is observed in patients by a combination of ailments such as headache, fever and loss of appetite.
- Headaches: These are headaches that are not usual. They often occur in the neck and temple area. These headaches often occur in the morning and at night and are sometimes located on the patient’s forehead.
- Jaw pain: These pains appear in the tongue or jaw area when Horton’s disease first appears. They occur mostly during chewing. Pain on palpation of the arteries as well as pain in the scalp;
- Visual disturbances: This is a sudden decrease in the acuity of vision without any pain. Sometimes, visions are blurred.
altered general condition: a person suffering from Horton’s disease often has an altered general condition. Also, the latter becomes tired with the least effort and suffers from fever. Sometimes they lose weight and appetite.
- Abnormalities in the blood test: the other characteristic or symptom that can be noticed when one has Horton’s disease is that the inflammatory syndrome is sometimes at a high rate in a blood test. This is quite an abnormality.
- Muscle pain: patients experience pain in their muscles. These pains that they feel are not minor, they are stiff pains.
Horton’s disease, complications
Horton’s disease, when it is not treated quickly, sometimes has complications that make it glaring and are related to a stop of the circulation in the inflammatory arteries.
- Ocular complications: These often occur when an artery that irrigates the patient’s eye becomes blocked. As a result, 1-2% of people with Horton’s disease are at risk of losing their vision. This is why it is important to consult a specialist as soon as you start to notice the symptoms. It is not a disease to be neglected.
- Psychiatric complications: They do not occur in a large number of patients, but only in 3%. With these complications, patients completely lose track of time and their bearings. They do not know where they are or how they got there. This is called temporo-spatial disorientation. Complications can also affect the patient’s lungs, kidneys, lower or upper limbs, heart arteries and aorta.
- Stroke: At this level, however, the artery may or may not become blocked. Note that 5% of people with Horton’s disease often experience these types of complications. It is also important to consult a specialist at this stage.
- Other vascular complications: These may include asymmetry of blood pressure or weight, aortic arch syndrome with claudication of the upper limbs caused by aortitis and aortic sheaf arteritis. These complications also affect the arteries, causing chronic cough and bronchopulmonary infiltrate. The digestion is also sometimes affected with a risk of mesenteric infarction and high blood pressure.
Horton’s disease, treatments
The basic treatment to be used is corticosteroid therapy which is a medication to be taken at a high dose for a long period of time. It is the only effective medication that allows patients to quickly regain their strength. It is the strongest anti-inflammatory known.
Already in 7 days, the improvement of your disease is at an advanced stage. The rapid regression of signs, characteristic of Horton’s disease from the very first days of treatment, should not be subject to the withdrawal of corticosteroid therapy. In other words, you should not stop taking corticosteroids when you notice that the signs are beginning to disappear. You should continue taking the steroid for several days, up to 18 days. However, other treatments are possible.
Attack treatment: When there is evidence of biopsy or a threat of eye damage, it is important to start this treatment quickly. Corticosteroid therapy does not alter the temporal artery biopsy when it is performed quickly.
Prednisone at a dose of one milligram per kilogram of body weight daily is the mainstay of this treatment. To reduce the initial ischemic complications, however, the patient may be given an antiaggregant therapy consisting of aspirin in a reliable dose or an anticoagulant therapy. The risk of blindness caused by ocular symptoms often leads some physicians to start treatment with intravenous corticosteroid infusions with a high dose of one gram of methylprednisolone each day for 3 days.
After taking this medication, the patient can also take oral prednisone with the daily dose of one milligram per kilogram. These doses of medication are more efficient and effective for the emergency and are able to promote a rapid decrease in corticosteroid therapy. It should be noted, however, that complications may arise during boluses.
Post attack phase: during this phase, corticosteroid therapy is gradually decreased. For example, the patient can decrease by 5 mg every 15 days up to 20 mg per day. After this stage, the dose can be further decreased until it is reduced to 1 mg every 15 days, keeping in mind that this treatment must last at least 2 years.
It is a treatment that often starts with high doses, but which are then gradually reduced. Indeed, it is important to point out that mixing the use of another drug with corticosteroid therapy can also facilitate the treatment of rare forms that do not comply with corticosteroids. This combination may also allow for a decrease in corticosteroid dependence and improved tolerance. In other words, cortico-dependence is the reappearance of signs during the decrease of corticosteroid boluses.
HOWEVER, WE MUST EMPHASIZE THAT DESPITE THE EFFECTIVENESS OF DAPSONE IN THIS INDICATION, IT IS NOT ACCEPTED BY ALL PATIENTS. BECAUSE IT IS SOMETIMES THE MAIN CAUSE OF ALLERGIC ACCIDENTS WHICH ARE SERIOUS.
Immunosuppressive drugs such as azathioprine and methotrexate are no longer in need of proof. They have proven to be very effective in Horton’s disease. Synthetic antimalarials have also played their part. Keep in mind that these drugs are really important and effective even if their interest has not yet been evaluated.
Given the undesirable side effects that the treatments may cause, it is still important that patients be monitored during treatment. This being the case, the elderly should be given special attention in order to prevent any increase in hypertension or eye disease.
The course of Horton’s disease
The signs of Horton’s disease often disappear dramatically when treatment is followed. Pain and fever improve in a short time. A few treatments are enough to make the inflammatory syndrome disappear. However, this should not be the end of the matter, as relapses can occur.
You should therefore continue the treatment for 18 months to two years. You should know that if the visual problems appear again, you can resort to the corticoid treatment to avoid visual loss. If this treatment is not given, the patient risks losing one or both eyes completely.
The onset of ocular complications is often announced with signs such as eye paralysis, blurred vision. It is important to remember that the arteries that supply the brain and the heart can be affected at any time. This state of affairs can therefore be the source of a myocardial infarction or a heart attack and then a stroke.
Diagnosing Horton’s disease
The diagnosis of Horton’s disease is often not easy, especially when it has not developed well. The symptoms can quickly lead doctors to believe that it is another disease. Special care must be taken by the physician at this level to avoid making a wrong diagnosis.
The doctor must ask the patient several questions about the characteristics and symptoms in order to better understand the disease. Blood tests can be done to verify the presence of inflammation and its importance. That is, the sedimentation rate. However, the confirmation of the diagnosis is possible thanks to the biopsy. This diagnosis is made by taking a sample of the patient’s temporal artery while under anesthesia.
Horton’s disease, food supplements
To avoid all possible complications, it is still important to follow a classical medical treatment. At the same time, the patient is also required to adopt a diet. Thus, the patient will have to eliminate foods that are cooked at a high temperature. Industrial sugar, cow’s milk based products, refined foods are among the foods that the patient must also avoid.
It should also be noted that another diet called hypotoxic diet is also good to follow for the improvement of the patient’s health. This diet consists of taking products from organic agriculture. The hypotoxic diet allows the suspension of corticosteroids after a period of 7 months of diet. So, here are some lists of foods that you can consume in case of Horton’s disease for a perfect improvement:
- the patient can take 2 capsules of the moducare three times during one week, 30 seconds before consuming his meal;
- 1 capsule of the effinat is to be taken 3 times. The patient can also take 8 immuno oils including 3 essential oils. This is done for 3 days in 1 capsule;
- Similarly, a massage of the temple with aromaderm can be applied;
- Another food supplement, it is kitocard Q 10. For this food supplement, the patient can take 2 capsules three times in a row.
It should also be noted that products such as Epa-krill and oxyolysis are also food supplements. The eppa-krill must be taken in 2 capsules during 2 months. Omega 3, gemmotherapy, ribes nigrum are also food supplements that fight against inflammation.
What to remember ?
Horton’s disease is a disease which comes from an inflammation of the wall of the temporal arteries. And even if its origin is not yet well known, Horton’s disease is nevertheless sensitive to factors that favor its occurrence. It is often characterized by fevers, headaches, migraines and jaw pain. Sometimes the symptoms of this disease tend to resemble the symptoms of other diseases. This makes it difficult to diagnose the disease, especially when it is in its early stages. However, the Horton’s disease patient can follow treatments for the improvement of his condition.
There are many dietary supplements that the patient can use to overcome this disease. It is important to remember that if the disease is not managed quickly, the patient may experience visual loss. It is therefore important to consult a doctor as soon as the first symptoms of Horton’s disease appear in order to avoid any complication.