Temporal arteritis: the silent presentation and delay in diagnosis.
To determine the frequency of the so-called silent or occult presentation of temporal arteritis (presentation with mere constitutional symptoms) and the resulting delay in diagnosis in this particular group, the medical records of all patients (n = 82) with temporal arteritis or polymyalgia rheumatica, presenting between 1982 and 1988 at the Department of General Internal Medicine of the University Hospital, were retrospectively analysed. Only biopsy-proven cases (n = 34) were studied further. Of the 34 patients with temporal arteritis, 13 (38%) presented with the silent or occult form. In this group the mean delay in diagnosis was 21.5 d (range 2-105) in contrast to a delay of 8.5 d (range 1-40) in the other group (P less than 0.05). Increased awareness of this presentation should lead to earlier diagnosis and treatment of this potentially life-threatening disease, resulting in a shorter hospital stay and fewer technical investigations, with a considerable financial saving.
Desmet
G D
GD
Department of Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.
Knockaert
D C
DC
Bobbaers
H J
HJ
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis; D001706:Biopsy; D005260:Female; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000175:diagnosis; D013699:Temporal Arteries / Q000473:pathology; D013997:Time Factors