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R.O. Kwon, A.C. Cirino, P.J. Bryar; Long–Term Outcomes of Patients with Negative Temporal Artery Biopsies. . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5601.
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Purpose:The diagnosis and treatment of patients with negative temporal artery biopsies is a dilemma for physicians. Previous studies have demonstrated that 21% of patients with negative temporal artery biopsies have subsequently been diagnosed with malignancy. The purpose of this study was to compare clinical history, exam findings, laboratory results, and eventual clinical diagnoses in patients with positive and negative temporal artery biopsies. Methods: Retrospective chart review was performed on 61 patients at the Northwestern Medical Faculty Foundation with a history of a temporal artery biopsy over the last 15 years. Average follow–up was 3.06yrs (range 1–138mo). Results: Patients with positive biopsies tended to present with jaw claudication or scalp tenderness (48% and 50% respectively), while patients with negative biopsies rarely presented with these symptoms (9% and 15% respectively). In both groups, patients commonly presented with headaches (>50%). There was no statistically significant difference between the sedimentation rates of the positive and negative biopsy groups. The two groups of patients had similar comorbid diseases, including hypertension (HTN), coronary artery disease (CAD), and arthritis. The incidence of subsequent malignancy, including prostate, colon, renal cell, and cutaneous squamous cell carcinoma were similar in patients with positive and negative biopsies (14% and 13% respectively). Diabetes was highly prevalent (33%) in patients with negative biopsies and only 15% in patients with positive biopsies. Conclusions: Of all patients biopsied, 77% had negative biopsy results. In both groups, there was no statistically significant difference in ESR or in the incidence of diseases such as CAD, HTN, arthritis, and subsequent malignancy. Patients with positive biopsies had a higher incidence of jaw claudication and scalp tenderness. Patients with negative biopsies had higher incidence of diabetes. These distinguishing characteristics between patients with positive and negative biopsies help guide the diagnosis, treatment, and subsequent follow–up of patients with presumed temporal arteritis.
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