Aghdam Kaveh Abri, Sanjari Mostafa Soltan, Manafi Navid, Khorramdel Shabnam, Alemzadeh Sayyed Amirpooya, Navahi Roshanak Ali Akbar
Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
J Ophthalmic Vis Res. 2020 Apr 6;15(2):201-209. doi: 10.18502/jovr.v15i2.6738. eCollection 2020 Apr-Jun.
To assess the use of temporal artery biopsy (TAB) in diagnosing giant cell arteritis (GCA) and to evaluate patients' clinical and laboratory characteristics.
We conducted a retrospective chart review of patients with suspected GCA who underwent TAB and had complete workup in a tertiary center in Iran between 2008 and 2017. The 2016 American College of Rheumatology (ACR) revised criteria for early diagnosis of GCA were used for each patient for inclusion in this study.
The mean age of the 114 patients in this study was 65.54 10.17 years. The mean overall score according to the 2016 ACR revised criteria was 4.17 1.39, with 5.82 1.28 for positive biopsies and 3.88 1.19 for negative biopsies (p <0.001). Seventeen patients (14.9%) had a positive biopsy. Although the mean post-fixation specimen length in the biopsy-positive group (18.35 6.9 mm) was longer than that in the biopsy-negative group (15.62 8.4 mm), the difference was not statistically significant ( = 0.21). There was no statistically significant difference between the groups in terms of sex, serum hemoglobin, platelet count, and erythrocyte sedimentation rate. There were statistically significant differences between the biopsy-negative and biopsy-positive groups with respect to patients' age and C-reactive protein level ( 001 and = 0.012, respectively).
The majority of TABs were negative. Reducing the number of redundant biopsies is necessary to decrease workload and use of medical services. We suggest that the diagnosis of GCA should be dependent on clinical suspicion.
评估颞动脉活检（TAB）在巨细胞动脉炎（GCA）诊断中的应用，并评估患者的临床和实验室特征。
我们对2008年至2017年间在伊朗一家三级中心接受TAB且检查完整的疑似GCA患者进行了回顾性病历审查。本研究中，每位患者均采用2０16年美国风湿病学会（ACR）修订的GCA早期诊断标准。
本研究中114例患者的平均年龄为65.54±10.17岁。根据2016年ACR修订标准，总体平均评分为4.17±1.39，活检阳性患者评分为5.82±1.28，活检阴性患者评分为3.88±1.19（p<0.001）。17例患者（14.9%）活检呈阳性。尽管活检阳性组固定后标本的平均长度（18.35±6.9mm）长于活检阴性组（15.62±8.4mm），但差异无统计学意义（P=0.21）。两组在性别、血清血红蛋白、血小板计数和红细胞沉降率方面无统计学差异。活检阴性组和活检阳性组在患者年龄和C反应蛋白水平方面存在统计学差异（分别为P<0.001和P=0.012）。
大多数TAB结果为阴性。减少不必要的活检数量对于减轻工作量和医疗服务使用是必要的。我们建议GCA的诊断应依赖于临床怀疑。
