title: Clinical course and management of a consecutive series of patients with "healed temporal arteritis".
abstract: OBJECTIVE
  To describe the clinical course and management of patients with a pathologic diagnosis of "healed" giant cell arteritis (GCA), and to determine whether previously published histological descriptions of healed arteritis can identify patients with a greater likelihood of clinically significant arteritis.
  
  
  METHODS
  All temporal artery biopsy reports between 1994 and 2003 were examined for a diagnosis of "healed arteritis." Two rheumatologists abstracted the medical record for presenting features, physical findings, comorbid conditions, and data on treatment and outcomes. One pathologist, blinded to the clinical data, reviewed all specimens and reinterpreted the biopsies according to published histological descriptions of healed arteritis.
  
  
  RESULTS
  Forty-seven patients with an initial pathologic diagnosis of healed arteritis were identified. In 54% of these patients, corticosteroid therapy did not change after the diagnosis of healed arteritis was documented in the pathology report. Seventy percent were ultimately treated with no corticosteroids or low-moderate corticosteroid regimens. Only 32% of the initial cases were confirmed upon review of the biopsies using standardized histological criteria. Patients with confirmed healed arteritis were more likely to have a documented history of polymyalgia rheumatica/GCA and a longer duration of corticosteroid treatment before biopsy. These patients were not more likely to have adverse outcomes.
  
  
  CONCLUSIONS
  In this case series, the diagnosis of healed arteritis had little effect on treatment decisions. In most cases, the initial pathologic diagnosis of healed arteritis was not confirmed when biopsies were reviewed by a single pathologist using uniform histological criteria.
authors: Division of Rheumatology, Immunology and Allergy, Department of Pathology and Department of Neurology, Brigham and Women’s Hospital, Boston, MA 02115, USA. ylee9@partners.org
authors: Yvonne C
authors: YC
authors: Lee
authors: Robert F
authors: RF
authors: Padera
authors: Erika H
authors: EH
authors: Noss
authors: Anne H
authors: AH
authors: Fossel
authors: Don
authors: D
authors: Bienfang
authors: Matthew H
authors: MH
authors: Liang
authors: William P
authors: WP
authors: Docken
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D013700:Giant Cell Arteritis / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000175:diagnosis
chemical_list: D000305:Adrenal Cortex Hormones