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J. A. Liss, C. Chiu, K. Dolphin, B. Levine, E. T. Kim; Clincal and Laboratory Factors Predictive of Temporal Artery Biopsy Results. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5489.
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Giant cell arteritis is a debilitating disease with the potential to cause bilateral blindness, and a high level of clinical suspicion must be maintained to prevent missing the diagnosis. Several reviews have been performed to determine which clinical signs and symptoms and laboratory results are reliable predictors of temporal artery biopsy results. Based on a review of the current literature, jaw claudication, visual changes and constitutional symptoms are fair predictors of a positive biopsy result, and a normal sedimentation rate (ESR) and lack of temporal artery abnormalities are predictive of a negative biopsy result. Our aim was to further determine which clinical and laboratory factors are correlated with temporal artery biopsy result. (Note: Chart review is still underway and there will be a larger sample size at the time of presentation)
We reviewed 40 consecutive temporal artery biopsies performed at a single institution over a 3 year period. Factors considered were patient's age and gender, presence of constitutional symptoms, temporal artery abnormalities or related symptoms, ESR, length of biopsy, and biopsy result.
6 of the 40 biopsies were positive. All 6 patients with positive biopsies were female. There was a trend toward a higher incidence of constitutional symptoms in the patients with positive biopsies compared to those with negative biopsies. Two of the patients with positive biopsies had a normal ESR. The mean age, ESR, frequency of temporal artery abnormalities, visual changes, jaw claudication and headache, as well as length of biopsy sample were similar between the two groups.
In this sampling, female gender and the presence of constitutional symptoms were predictors of a positive biopsy result. ESR and symptoms related to temporal artery abnormalities were not predictive of biopsy result.
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