Analysis of temporal artery biopsies in an 18-year period at a community hospital.
OBJECTIVE
To identify analytical and clinical variables that may improve the effectiveness of temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA).


METHODS
A retrospective study of TABs conducted between 1989 and 2007 at the 450-bed Hospital Parc Taulí, Sabadell. Demographic data, clinical manifestations, analytical data prior to the biopsy and final diagnoses were recorded, including only those cases in which these data were reflected in the clinical history.


RESULTS
In this period, 278 TABs were conducted in 181 women (65.1%) and 97 men (mean age 74 years). Seventy-nine (28.4%) were positive (GCA+) and 199 (71.5%) negative (TAB-). The most frequent final diagnoses in the TAB- group were: polymyalgia rheumatica (PMR) (18.6%), giant cell arteritis plus negative TAB (GCA-) (13.6%), tension headache (7.5%), infection (7.5%), other vasculitis (7.5%), and neoplasm (6.0%). The GCA+ group was compared with the TAB- group, the GCA- group and the PMR group. In the multivariate analysis only headache (RR 3.6), jaw claudication (RR 2.9) and abnormal temporal artery on palpation (RR 2.5) revealed statistical differences between the GCA+ and TAB- groups.


CONCLUSIONS
One third of the biopsies performed at our centre were positive for GCA. The clinical variables that best predicted a positive TAB in our series were headache, jaw claudication, and abnormal temporal artery on palpation.
Marí
B
B
Internal Medicine Service, Hospital de Sabadell, Fundació Parc Tauli-Institut Universitari (UAB), 08208 Sabadell, Barcelona, Spain. Bmari@tauli.cat
Monteagudo
M
M
Bustamante
E
E
Pérez
J
J
Casanovas
A
A
Jordana
R
R
Tolosa
C
C
Oristrell
J
J
D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications / Q000473:pathology*; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000175:diagnosis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain; D013699:Temporal Arteries / Q000473:pathology*