Evaluation for clinical predictors of positive temporal artery biopsy in giant cell arteritis.
OBJECTIVE
To examine the clinical predictors of a positive temporal artery biopsy (TAB) among patients suspected of having giant cell arteritis.


METHODS
We conducted a retrospective study of all consecutive patients who underwent TAB by a single surgeon (K.L.R.) at the Department of Oral Maxillofacial Surgery from April 30, 2002, to June 29, 2006. The medical records were reviewed for the clinical symptoms, laboratory findings, biopsy results, and final diagnosis. The variables of interest as predictors of positive biopsy findings were analyzed using logistic regression analysis.


RESULTS
During the study period, 82 patients underwent TAB. Histologic evidence of arteritis was present in 22 patients (26.8%). Two (2.4%) were diagnosed with giant cell arteritis clinically but had negative TAB findings. The patients presenting with weight loss or jaw claudication were more likely to have a positive TAB finding (odds ratio 4.50, 95% confidence interval 1.45 to 13.93; and odds ratio 3.71, 95% confidence interval 1.28 to 10.76, respectively). No laboratory findings were predictive of a positive TAB finding. Prednisone use before TAB also was not associated with a decreased likelihood of a positive finding.


CONCLUSIONS
Patients suspected of having giant cell arteritis were more likely to have a positive TAB finding if they presented with weight loss or jaw claudication. In the present series, corticosteroid therapy before biopsy did not affect the rate of positive TAB findings.
Rieck
Kevin L
KL
Division Oral and Maxillofacial Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Kermani
Tanaz A
TA
Thomsen
Kristine M
KM
Harmsen
William S
WS
Karban
Matthew J
MJ
Warrington
Kenneth J
KJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000855:Anorexia / Q000503:physiopathology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000503:physiopathology; D005544:Forecasting; D013700:Giant Cell Arteritis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006261:Headache / Q000503:physiopathology; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology; D007571:Jaw Diseases / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000503:physiopathology; D011111:Polymyalgia Rheumatica / Q000175:diagnosis; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D012535:Scalp / Q000473:pathology; D013699:Temporal Arteries / Q000473:pathology*; D014786:Vision Disorders / Q000503:physiopathology; D015431:Weight Loss / Q000502:physiology
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011241:Prednisone