Baldursson O, Steinsson K, Björnsson J, Lie J T
University Hospital, Reykjavík, Iceland.
Arthritis Rheum. 1994 Jul;37(7):1007-12. doi: 10.1002/art.1780370705.
To investigate the incidence and clinical and histopathologic features of giant cell (temporal) arteritis (GCA) in the Caucasian population of Iceland.
All patients diagnosed between 1984 and 1990 were included. Case ascertainment for the study was done in 2 ways: 1) a computerized search from all hospitals and primary care clinics for the diagnosis of GCA, and 2) a review of all temporal artery biopsies performed during the 7-year period.
One hundred thirty-three patients with GCA were identified. All fulfilled the 1990 American College of Rheumatology criteria for the classification of GCA. The incidence rate for the population 50 years and older was 27/100,000 (36/100,000 and 18/100,000 for women and men, respectively). Clinical findings included the following: mean age at diagnosis 72.5 years for women and 70.3 years for men, new headache 63.2%, abnormal temporal artery on palpation 43.6%, mean erythrocyte sedimentation rate 88 mm/hour, symptoms of polymyalgia rheumatica 48.1%, and visual disturbances 14.3%. A total of 744 patients underwent temporal artery biopsy during the 7-year period; 16.8% had a positive biopsy result. All 133 patients with the diagnosis of GCA underwent a temporal artery biopsy; 94% had a positive result. Histopathologic findings from the positive biopsies included a fragmented internal elastic lamina in 99.2%, giant cells in 65.6%, and fibrinoid necrosis in 12%.
Compared with previous epidemiologic surveys, this study shows a high incidence of biopsy-proven GCA in Iceland.
调查冰岛白种人群中巨细胞（颞）动脉炎（GCA）的发病率以及临床和组织病理学特征。
纳入1984年至1990年间确诊的所有患者。该研究通过两种方式确定病例：1）从所有医院和初级保健诊所进行计算机检索以诊断GCA，2）回顾7年期间所有进行的颞动脉活检。
共识别出133例GCA患者。所有患者均符合1990年美国风湿病学会GCA分类标准。50岁及以上人群的发病率为27/100,000（女性为36/100,000，男性为18/100,000）。临床发现包括：女性诊断时的平均年龄为72.5岁，男性为70.3岁，新发头痛63.2%，触诊颞动脉异常43.6%，平均红细胞沉降率88毫米/小时，风湿性多肌痛症状48.1%，视觉障碍14.3%。7年期间共有744例患者接受了颞动脉活检；活检结果阳性的占16.8%。所有133例诊断为GCA的患者均接受了颞动脉活检；94%结果为阳性。阳性活检的组织病理学发现包括内弹性膜断裂99.2%，巨细胞65.6%，纤维蛋白样坏死12%。
与以往的流行病学调查相比，本研究显示冰岛经活检证实的GCA发病率较高。
