title: Demographic and laboratory data may predict positive temporal artery biopsy.
abstract: BACKGROUND
  Temporal artery biopsy is performed in patients suspected of having giant cell arteritis. This study was conducted to evaluate clinical and laboratory criteria correlating with positive biopsy results in an effort to limit the number of negative biopsies performed.
  
  
  METHODS
  A retrospective review was performed of patients who underwent temporal artery biopsy at two urban medical centers from 2002 to 2009. A multivariate analysis of patient demographics, clinically relevant signs and symptoms, laboratory data, and pathologic outcomes was performed.
  
  
  RESULTS
  Temporal artery biopsy histologically confirmed giant cell arteritis in 24% of cases. The mean age of those with disease was 77.8 y and those without were 73.1 y; age was found to be statically significant (P = 0.0227); 76% were female and 24% were male; gender was not significant (P = 0.9594); 42% were Caucasian (39% had a positive temporal artery biopsy), 27% were Hispanic (17% positive), and 31% of the patients were African-American (3% positive); ethnicity was significant (P = 0.0005). The PPV of elevated ESR was 27%; sensitivity was 100%; specificity was 16%. A history of headache or visual disturbance was not predictive of a positive biopsy
  
  
  CONCLUSIONS
  Fewer negative biopsy results may be achieved by screening patients with normal ESR or lower risk patients with other modalities.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, Beth Israel Medical Center, New York, New York, USA.
authors.forename: Joanelle Z
authors.initials: JZ
authors.lastname: Lugo
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Deitch
authors.forename: Andrew
authors.initials: A
authors.lastname: Yu
authors.forename: Joon Ho
authors.initials: JH
authors.lastname: Jang
authors.forename: Radha
authors.initials: R
authors.lastname: Patel
authors.forename: Denisa
authors.initials: D
authors.lastname: Slova
authors.forename: John
authors.initials: J
authors.lastname: Lantis
authors.forename: I Michael
authors.initials: IM
authors.lastname: Leitman
mesh_terms: D017677:Age Distribution; D000368:Aged; D001706:Biopsy / Q000706:statistics & numerical data*; D005260:Female; D013700:Giant Cell Arteritis / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity