Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2010
Evaluation for clinical predictors of positive temporal artery biopsy in giant cell arteritis.
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Rieck Kevin L, Kermani Tanaz A, Thomsen Kristine M, Harmsen William S, Karban Matthew J, Warrington Kenneth J
Аннотация
PURPOSE: To examine the clinical predictors of a positive temporal artery biopsy (TAB) among patients suspected of having giant cell arteritis.
PATIENTS AND METHODS: We conducted a retrospective study of all consecutive patients who underwent TAB by a single surgeon (K.L.R.) at the Department of Oral Maxillofacial Surgery from April 30, 2002, to June 29, 2006. The medical records were reviewed for the clinical symptoms, laboratory findings, biopsy results, and final diagnosis. The variables of interest as predictors of positive biopsy findings were analyzed using logistic regression analysis.
RESULTS: During the study period, 82 patients underwent TAB. Histologic evidence of arteritis was present in 22 patients (26.8%). Two (2.4%) were diagnosed with giant cell arteritis clinically but had negative TAB findings. The patients presenting with weight loss or jaw claudication were more likely to have a positive TAB finding (odds ratio 4.50, 95% confidence interval 1.45 to 13.93; and odds ratio 3.71, 95% confidence interval 1.28 to 10.76, respectively). No laboratory findings were predictive of a positive TAB finding. Prednisone use before TAB also was not associated with a decreased likelihood of a positive finding.
CONCLUSIONS: Patients suspected of having giant cell arteritis were more likely to have a positive TAB finding if they presented with weight loss or jaw claudication. In the present series, corticosteroid therapy before biopsy did not affect the rate of positive TAB findings.
PATIENTS AND METHODS: We conducted a retrospective study of all consecutive patients who underwent TAB by a single surgeon (K.L.R.) at the Department of Oral Maxillofacial Surgery from April 30, 2002, to June 29, 2006. The medical records were reviewed for the clinical symptoms, laboratory findings, biopsy results, and final diagnosis. The variables of interest as predictors of positive biopsy findings were analyzed using logistic regression analysis.
RESULTS: During the study period, 82 patients underwent TAB. Histologic evidence of arteritis was present in 22 patients (26.8%). Two (2.4%) were diagnosed with giant cell arteritis clinically but had negative TAB findings. The patients presenting with weight loss or jaw claudication were more likely to have a positive TAB finding (odds ratio 4.50, 95% confidence interval 1.45 to 13.93; and odds ratio 3.71, 95% confidence interval 1.28 to 10.76, respectively). No laboratory findings were predictive of a positive TAB finding. Prednisone use before TAB also was not associated with a decreased likelihood of a positive finding.
CONCLUSIONS: Patients suspected of having giant cell arteritis were more likely to have a positive TAB finding if they presented with weight loss or jaw claudication. In the present series, corticosteroid therapy before biopsy did not affect the rate of positive TAB findings.
Предметные рубрики MeSH
AdultAgedAged, 80 and overAnorexiaAnti-Inflammatory AgentsBiopsyDiagnosis, DifferentialFemaleFeverForecastingGiant Cell ArteritisGlucocorticoidsHeadacheHumansIntermittent ClaudicationJaw DiseasesMaleMiddle AgedNeck PainPolymyalgia RheumaticaPrednisoneRetrospective StudiesScalpTemporal ArteriesVision DisordersWeight Loss