GCA flare with Covid

[Shanghi]

Hi everyone, I have been on 7.5mg prednisone since beginning of Mar. down from 60 mg last Apr. (onset of GCA). My rheumy in Canada, had me taper from 10mg to 7.5, even though I wanted to do 1mg.

However everything went well & I never had a flare. I'm in Spain now for 3 mos (my little family lives here) & I'm supposed to taper down to 5 mg. over the next few mos.

Now comes the clincher, after being safe for last few yrs. I tested positive for Covid this Sun. I started feeling the same kind of pain that I had initially when my GCA started. Walking by the windy beach,on Sun. ear pain & then In the head occasional shooting jabs, so I figured this must be a flare. I increased to 10 mg. on Tues.& Wed, but it hasn't stopped, the shooting pains are mostly during the night, not very bad, but of concern & also feel occasionally some type of pressure(?) on top of skull. The Covid seems to be getting better although I had to go to local clinic yesterday for antibiotics (hematuria - from Covid?).

I asked someone to contact my rheumy in Canada, but not available until after Easter.

I just wanted to know how much to up prednisone by (fb group recommended double dose), so this morning I took 15 mg.

What I want to know how many days do I take this dose & if pain is gone how do I taper down to 7.5? Can it be done fast or does it take weeks?

Happy safe Easter to all!🐣

[DorsetLady PMRGCAuk volunteer]

This link contains usual procedure for flare - just amend example to your own doses etc - it’s usually add 5mg to last dose you felt ok, not double dose - but I’m sure you can sort it -healthunlocked.com/pmrgcauk...

[Shanghi in reply to DorsetLady]

Thx so much, tomorrow I will then take 12.5mg not 15 like today & see if that does the trick.😊

[SheffieldJane]

I would be concerned about this collection of symptoms, just in case they heralded GCA which can affect the ears. I think to be on the safe side, you should have this checked out in Spain. My own PMR morphed into GCA and this can put your eyesight at risk. It is also worth noting that your current taper is steeper and faster than the guidelines recommend. Have a look at FAQs on here. I honestly wouldn’t delay, the consequences “ could be” life changing. So sorry, what a thing to happen right now. Good luck! Covid seems to trip a lot of us into flares at the very least. Whatever, you need a higher dose of Pred and a taper that is never more than 10% of your dose. Look at tapers on FAQs as well as GCA symptoms. 🍀

[PMRpro Ambassador]

You actually also probably need that double dose under Sick Day Rules.

You can stay at a higher dose for up to 10-14 days and still drop back quickly though maybe in a couple of bigger steps rather than 1 big one after only a week.

Why did you need abx for haematuria? It is a rare atypical presentation of Covid which can cause kidney injury so do keep an eye on that - even mild Covid can do it so if it worsens - go back to a doctor sooner rather than later.

hopkinsmedicine.org/health/...

[Shanghi in reply to PMRpro]

Thx so much for your reply. I will monitor if flare diminishes with this double dose.The antibiotics, Fosfomicina, (2 doses, yesterday & today) was for suspected UTI, the burning & urgency sensation started Mon, the day after Covid symptoms started. Someone suggested I go to local clinic, they did urine analysis & found blood in urine. (I didn't see any),

[PMRpro Ambassador in reply to Shanghi]

Fair enough then - hope it all goes away very quickly!

[Shanghi]

😊🐣