Objective: To examine the clinical manifestations of 39 patients with temporal (giant cell) arteritis (GCA), allocated during a 10 year period in the largest medical center in Israel.
Methods: The patients were included in the analysis if they fulfilled the new American College of Rheumatology Classification Criteria for the diagnosis of GCA. Patients were divided into biopsy-proven (30 patients) and biopsy-negative (9 patients) groups, and their clinical manifestations were compared using Student's t test for comparison of continuous variables, and Fisher's exact test for comparison of proportions.
Results: The most common presenting symptoms of the patients with TA included headache (87% of the biopsy-proven patients), fever (64%), visual abnormalities (41%), and polymyalgia rheumatica (PMR) or weight loss (20% each). Pulmonary involvement occurred in 5 patients. Ten percent of the biopsy-proven patients presented with occult presentation. Analysis of biopsy-proven and biopsy-negative groups revealed the feasibility of making the diagnosis of temporal arteritis on the basis of simple clinical variables, even without a positive biopsy, as the 2 groups of patients had comparable manifestations. However, the biopsy-proven group was older, included more males and presented significantly more with fever, compared to the biopsy-negative patients. Moreover, although not reaching statistical significance, the biopsy-proven patients tended to have more systemic and extracranial symptoms, including pulmonary manifestations.
Conclusion: Compared to a previous report from Israel on patients with temporal arteritis, almost 2 decades ago, our data suggest that the incidence of the disease in Israel has increased, whereas the ethnic distribution has not changed.