title: Blinded search for varicella zoster virus in giant cell arteritis (GCA)-positive and GCA-negative temporal arteries.
abstract: Recent analysis of archived temporal arteries (TAs) acquired from 13 pathology laboratories in the US, Canada, Iceland, France, Germany and Israel from patients with pathologically-verified giant cell arteritis (GCA-positive) and TAs from patients with clinical features and laboratory abnormalities of GCA but whose TAs were pathologically negative (GCA-negative) revealed VZV antigen in most TAs from both groups. Despite formalin-fixation, VZV DNA was also found in many VZV-antigen positive sections that were scraped, subjected to DNA extraction, and examined by PCR with VZV-specific primers. Importantly, in past studies, the pathological diagnosis (GCA-positive or -negative) was known to the neurovirology laboratory. Herein, GCA-positive and GCA-negative TAs were provided by an outside institution and examined by 4 investigators blinded to the pathological diagnoses. VZV antigen was found in 3/3 GCA-positive TAs and in 4/6 GCA-negative TAs, and VZV DNA in 1/3 VZV antigen-positive, GCA-positive TAs and in 3/4 VZV antigen-positive, GCA-negative TAs. VZV DNA was also detected in one GCA-negative, VZV-antigen negative TA. Overall, the detection of VZV antigen in 78% of GCA-positive and GCA-negative TAs is consistent with previous reports on the prevalence of VZV antigen in patients with clinically suspect GCA.
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA; Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, CO, USA. Electronic address: don.gilden@ucdenver.edu.
authors.forename: Don
authors.initials: D
authors.lastname: Gilden
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: White
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Nelly
authors.initials: N
authors.lastname: Khmeleva
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Utah Health Sciences Center, Salt Lake City, UT, USA; Department of Neurology, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Katz
authors.affiliation: Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Nagel
mesh_terms: D004279:DNA, Viral / Q000235:genetics*; D013700:Giant Cell Arteritis / Q000378:metabolism / Q000473:pathology* / Q000821:virology; D006562:Herpes Zoster / Q000473:pathology* / Q000821:virology; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D013699:Temporal Arteries / Q000473:pathology / Q000821:virology*; D014764:Viral Proteins / Q000235:genetics / Q000276:immunology
chemical_list: D004279:DNA, Viral; D014764:Viral Proteins
keywords: Giant cell arteritis; Varicella zoster virus