RT Journal Article
SR Electronic
T1 Clinical Course and Management of a Consecutive Series of Patients with “Healed Temporal Arteritis”
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.110317
DO 10.3899/jrheum.110317
A1 Yvonne C. Lee
A1 Robert F. Padera
A1 Erika H. Noss
A1 Anne H. Fossel
A1 Don Bienfang
A1 Matthew H. Liang
A1 William P. Docken
YR 2011
UL http://www.jrheum.org/content/early/2011/11/27/jrheum.110317.abstract
AB Objective To describe the clinical course and management of patients with a pathologic diagnosis of “healed” giant cell arteritis (GCA), and to determine whether previously published histological descriptions of healed arteritis can identify patients with a greater likelihood of clinically significant arteritis. Methods All temporal artery biopsy reports between 1994 and 2003 were examined for a diagnosis of “healed arteritis.” Two rheumatologists abstracted the medical record for presenting features, physical findings, comorbid conditions, and data on treatment and outcomes. One pathologist, blinded to the clinical data, reviewed all specimens and reinterpreted the biopsies according to published histological descriptions of healed arteritis. Results Forty-seven patients with an initial pathologic diagnosis of healed arteritis were identified. In 54% of these patients, corticosteroid therapy did not change after the diagnosis of healed arteritis was documented in the pathology report. Seventy percent were ultimately treated with no corticosteroids or low-moderate corticosteroid regimens. Only 32% of the initial cases were confirmed upon review of the biopsies using standardized histological criteria. Patients with confirmed healed arteritis were more likely to have a documented history of polymyalgia rheumatica/GCA and a longer duration of corticosteroid treatment before biopsy. These patients were not more likely to have adverse outcomes. Conclusion In this case series, the diagnosis of healed arteritis had little effect on treatment decisions. In most cases, the initial pathologic diagnosis of healed arteritis was not confirmed when biopsies were reviewed by a single pathologist using uniform histological criteria.