Temporal artery biopsy in the diagnosis of giant cell arteritis: Bigger is not always better

Am J Surg. 2018 Apr;215(4):647-650. doi: 10.1016/j.amjsurg.2017.08.020. Epub 2017 Sep 1.

Abstract

Objective: Accurate early giant cell arteritis (GCA) diagnosis can be established through temporal artery biopsy (TAB). We herein investigate the relationship between specimen length and positive TAB result in a tertiary-care hospital in Germany during a 8-year period. Secondarily, we studied the relationships of specific epidemiological and laboratory parameters with positive TABs.

Method: We retrospectively reviewed the medical records of all patients with suspected GCA, who underwent TAB in our institution.

Results: The total sample consisted of 116 patients with a mean age of 76.1 (SD 7.7) years. Mean specimen length post-fixation was 0.94 cm (SD 0.49). The TAB(+) group consisted of 64 patients (55.2%). The specimen length was comparable in the two groups (0.96 cm vs 0.91 cm, p = 0.581). Twenty six TAB(+) patients (41%) had a post-fixation specimen longer than 1 cm, comparable with the respective percentage in the TAB(-) group (42%, p = 1). All laboratory tests performed were statistically significantly different in the two groups.

Conclusion: We conclude that TAB length is not associated with the TAB diagnostic yield in patients with clinical suspicion of GCA.

Keywords: Giant cell arteritis; Horton disease; Size; Specimen length; Temporal artery biopsy.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Biopsy / methods*
  • Female
  • Giant Cell Arteritis / diagnosis*
  • Giant Cell Arteritis / pathology
  • Humans
  • Male
  • Retrospective Studies
  • Temporal Arteries / pathology*

Substances

  • Biomarkers