Temporal arteritis. Clinical implications for the vascular surgeon.
Temporal arteritis is a systemic disease with local temporal artery symptoms, generalized constitutional symptoms and ocular involvement which affects the elderly. A study was undertaken to assess the clinical features of patients with temporal arteritis in a large multispecialty clinic practice. The study group consisted of 516 patients with clinical suspicion of temporal arteritis, of which 97 (18.8%) had a positive biopsy for arteritis. The records of these 74 females and 23 males were retrospectively reviewed for clinical implications of the disease. The average age of the cohort was 71.7 years, and male to female ratio was 1:3.2. There were 95 caucasians and 2 blacks. The most common clinical findings at presentation were abnormal temporal artery (65.9%), headache (64.8%), myalgias or arthralgias (46.6%), visual symptoms (37.1%) and fever (35.1%). Multiple symptoms were present in 97% of the patients. The erythrocyte sedimentation rate was > 50 mm per hour in 91% of patients. Corticosteroids were used to treat 95/97 patients. Twenty-seven (28%) of the patients completed treatment over an average 36.3 months. Sixty-eight (72%) other patients were either lost to follow-up, died, or continue on therapy. Complications of corticosteroid treatment occurred in 43 (44.3%) of patients, and complications of temporal arteritis occurred in 14 (14.4%). A review of biopsy data showed no difference in length of biopsy or yield of biopsy in the patients with positive and the patients with negative histology. Temporal arteritis is a systemic disease which responds well to corticosteroid treatment. Complications of the disease as well as of treatment make definitive diagnosis imperative.
Procter
C D
CD
Ochsner Clinic, New Orleans.
Hollier
L H
LH
Trosclair
C M
CM
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001799:Blood Sedimentation; D005260:Female; D005500:Follow-Up Studies; D013700:Giant Cell Arteritis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D008145:Louisiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital; D012189:Retrospective Studies; D012737:Sex Factors; D015996:Survival Rate; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones