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巨细胞动脉炎的实验室特征鉴别:一项真实世界的回顾性队列研究。

Distinguishing laboratory characteristics in giant cell arteritis: a real-world retrospective cohort study.

机构信息

Royal Adelaide Hospital, Adelaide, SA, 5000, Australia.

Department of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, SA, Australia.

出版信息

Int Ophthalmol. 2023 Nov;43(11):4197-4201. doi: 10.1007/s10792-023-02829-5. Epub 2023 Aug 29.

Abstract

BACKGROUND

Untreated Giant Cell Arteritis (GCA) has the potential to cause serious complications such as vision loss. Appropriate initial assessment by General Practitioners, early treatment and specialist referral are therefore essential in reducing morbidity. However, lack of awareness around the range of presentations can lead to a delay in diagnosis.

OBJECTIVE

We aim to evaluate the discriminative diagnostic performance of laboratory characteristics associated with GCA in our population over a period of 18 months.

DISCUSSION

This is a real-world retrospective review of patients referred to ophthalmology services with concern for GCA. The pre-test probability of a patient referred with suspected GCA was 13.9% to have GCA, highlighting the need for specialist referrals to continue. White Cell Count (p = 0.01), Platelet Count (p = 0.02), Erythrocyte sedimentation rate (p = 0.004) and C-reactive protein (p = 0.002) were significantly different between GCA and non-GCA cases. Moreover, this study demonstrates that absolute neutrophil count (p = 0.02) can be a useful parameter in initial investigations for GCA.

摘要

背景

未经治疗的巨细胞动脉炎(GCA)有可能导致严重的并发症,如视力丧失。因此,全科医生进行适当的初步评估、早期治疗和专科转诊对于降低发病率至关重要。然而,对各种表现的认识不足可能导致诊断延迟。

目的

我们旨在评估在 18 个月的时间内与我们人群中的 GCA 相关的实验室特征的鉴别诊断性能。

讨论

这是对因怀疑 GCA 而转至眼科服务的患者进行的真实世界回顾性研究。因疑似 GCA 而转介的患者的 GCA 前期概率为 13.9%,突出了继续进行专科转诊的必要性。白细胞计数(p=0.01)、血小板计数(p=0.02)、红细胞沉降率(p=0.004)和 C 反应蛋白(p=0.002)在 GCA 与非 GCA 病例之间存在显著差异。此外,本研究表明绝对中性粒细胞计数(p=0.02)可作为 GCA 初始检查的有用参数。

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