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S. Trikha, A. Lockwood, J. Kirwan; Biopsy Positive Temporal (Giant-cell) Arteritis - Is a Higher Inflammatory Response Associated With Visual Loss?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4018.
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To investigate the correlation with inflammatory markers of patients with biopsy proven Temporal Arteritis. Secondary outcomes were to assess socioeconomic status and overall incidence
All patients referred for Temporal Artery biopsy at a single centre over a three year period were included. Inflammatory markers Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP) and serum platelet count were compared between biopsy positive and negative samples, along with visual loss and no visual loss groups. Index of deprivation scores from the national database were compared to a cataract surgery group (control) to determine socioeconomic status.
Biopsy positive age adjusted incidence was 29.3/100000. 111 Temporal Artery biopsies were performed; 33 were positive cases (B+ve) and 78 negative for GCA(B-ve). Mean age at biopsy was 74.5 years. 93% of cases referred for biopsy were subsequently diagnosed with GCA on clinical grounds. Mean CRP was 50.75 in the B-ve group versus 98.0 in the B+ve group (p<0.001), and mean ESR was 53.9 (B-ve) versus 69.9 (B+ve) (p<0.018). Mean platelet count was 359.7 (B-ve) compared to 438.8 (B+ve) (p<0.001). A higher inflammatory response was not observed in B+ve visual loss group versus B+ve no visual loss (p <0.847, Mann Whitney U test). Statistically insignificant differences in socioeconomic status were found in biopsy positive group compared to controls (p=0.112)
Biopsy positive GCA was associated with significant elevations in serum platelet count, ESR and CRP levels compared to biopsy negative GCA, although visual loss in positive samples did not appear to correlate with inflammatory marker levels. GCA appears unrelated to socioeconomic status in this cohort. A large proportion of biopsies were negative or inconclusive - warranting strict criteria for biopsy referral.
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