Influence of Previous Corticosteroid Therapy on Temporal Artery Biopsy Yield in Giant Cell Arteritis
Section snippets
Patients and Methods
We conducted a retrospective study of all patients diagnosed with GCA by the Department of Rheumatology within the Hospital Universitario de Bellvitge (Barcelona, Spain) from January 1986 until December 2004. We primarily determined, from medical records, whether each patient had received steroid treatment before TAB.
During this time, a total of 121 patients were diagnosed with GCA; 78 patients (64%) who received corticosteroids before biopsy were eligible to be included in our study. The
Study Sample and Overall Biopsy Results
The main clinical features and laboratory data of the 78 patients included in the study are summarized in Table 1. All patients were referred to the hospital from the primary care unit or they self-referred to the emergency room. The principle motives for the initiation of corticosteroid treatment before TAB were the presence of visual manifestations at diagnosis (18 cases), delay in performance of the biopsy due to surgical waiting lists (27 cases), and institution of steroid treatment by
Discussion
Patients with untreated GCA are more susceptible to blindness (which is generally irreversible unless aggressively treated within 24 to 48 hours of onset), strokes, and other manifestations of cranial ischemic complications. This has led to a general consensus among clinicians that corticosteroid treatment is necessary in subjects with suspected GCA. Most authorities recommend starting the therapy as soon as the diagnosis is suspected; as a result, initiation of corticosteroids on clinical
References (36)
- et al.
Is temporal artery biopsy prudent?
Mayo Clin Proc
(1984) - et al.
The therapeutic impact of temporal artery biopsy
Lancet
(1983) - et al.
Temporal arteritis: a clinicopathologic study
Ophthalmology
(1986) - et al.
Biopsy-negative giant cell arteritis: clinical spectrum and predictive factors for positive temporal artery biopsy
Semin Arthritis Rheum
(2001) - et al.
Temporal artery biopsy after one month of corticosteroid therapy
Am J Ophthalmol
(1994) - et al.
Temporal arteritis and polymyalgia rheumatica in north-eastern Spain: clinical spectrum and relationship over a 15 year period
Joint Bone Spine
(2003) - et al.
Polymyalgia rheumaticaDuration of therapy and long-term outcome
Am J Med
(1985) - et al.
Giant-cell arteritis and polymyalgia rheumatica
Ann Intern Med
(2003) - et al.
Does this patient have temporal arteritis?
JAMA
(2002) - et al.
Temporal arteritis and polymyalgia rheumaticaClinical and biopsy findings
Ann Intern Med
(1972)