Temporal Artery Biopsy for Diagnosing Giant Cell Arteritis: A Ten-year Review

Aghdam, Kaveh Abri; Sanjari, Mostafa Soltan; Manafi, Navid; Khorramdel, Shabnam; Alemzadeh, Sayyed Amirpooya; Navahi, Roshanak Ali Akbar

doi:10.18502/jovr.v15i2.6738

Cited by 16 publications

(22 citation statements)

References 31 publications

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“…[7] Among the 95 suspected GCA cases with negative TABs, we reviewed the medical records of 50 patients whose mean overall rACR score was 3.86 ± 1.12. These results were similar to those of Abri Aghdam et al [37] (mean score of 3.88 ± 1.19 for negative biopsies). In addition, the mean overall rACR score of the eight patients with positive-TABs in our study was 5.87.…”

Section: Resultssupporting

confidence: 91%

The Adequate Number of Histopathology Cross-sections of Temporal Artery Biopsy in Establishing the Diagnosis of Giant Cell Arteritis

Navahi

Chaibakhsh

Alemzadeh

et al. 2021

JOVR

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Purpose: To determine the appropriate number of histopathological cross-sections that are required for a conclusive diagnosis of giant cell arteritis (GCA). Methods: In this cross-sectional study, the number of sections per slide for paraffin-embedded blocks for 100 randomly selected cases where GCA was suspected and those for negative temporal artery biopsies (TABs) were compared with the number of cross-sections per specimen for eight positive-TABs. All aforementioned examinations were conducted at our center from 2012 to 2016. Then, negative-TABs were retrieved and re-evaluated using light microscopy considering the histopathological findings of GCA. Results: Ninety-five paraffin blocks were retrieved. The original mean biopsy length was 15.39 ± 7.56 mm. Comparison of the mean number of cross-sections per specimen for both the positiveand negative-TABs (9.25 ± 3.37 and 9.53 ± 2.46) showed that 9.87 ± 2.77 [95% confidence intervals (CI)] cross-sections per specimen were sufficient for a precise GCA diagnosis. There was no statistically significant difference in the mean biopsy length (P = 0.142) among the eight positive-TABs. Similarly, no significant difference was observed in the number of cross-sections per specimen (P = 0.990) for positive-TABs compared to those for the negative-TABs. After the retrieval of negative-TABs, the mean number of total pre- and post-retrieval cross-sections per specimen was 17.66 ± 4.43. Among all retrieved specimens, only one case (0.01%) showed the histopathological features of healed arteritis. Conclusion: Positive-TABs did not reveal more histological cross-sections than the negative ones and increasing the number of cross-sections did not enhance the accuracy of TAB.

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Section: Resultssupporting

confidence: 91%

The Adequate Number of Histopathology Cross-sections of Temporal Artery Biopsy in Establishing the Diagnosis of Giant Cell Arteritis

Navahi

Chaibakhsh

Alemzadeh

et al. 2021

JOVR

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“…We determined that TAB positivity increases with age and is more common in women. Similar to our observation, there are studies reporting a higher mean age in TAB-positive patients than in TAB-negative patients, and that ≤ 70 years should downgrade the level of suspicion for GCA [23,24]. On the contrary, there are publications in the literature reporting that age is not associated with TAB positivity [25,26].…”

Section: Discussionsupporting

confidence: 88%

Giant Cell (Temporal) Arteritis: The Rate and Clinical Predictors of Histopathological Diagnosis

Yücel

Gün

et al. 2021

Preprint

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Purpose To determine the rate of histopathological diagnosis by temporal artery (TA) biopsy (TAB) and the predictive clinical features of TAB positivity in patients with giant cell arteritis (GCA). Methods The records of patients who underwent TAB with pre-diagnosis of GCA between January 2006 and May 2020 were retrospectively reviewed. The demographic characteristics, symptoms, clinical and laboratory findings, TAB data, and the medications of the patients were recorded. The patients were divided into two groups as TAB-negative and TAB-positive, and compared clinically. Factors affecting TAB positivity were determined. Results TAB confirmed the diagnosis of GCA in 48% of our cases. The median fixed TAB specimen length was 1.7 (0.5–4.0) mm. TAB positivity increased with age (74 vs. 66 years, p = 0.027) and was more common in women (91.7% vs. 38.5%, p = 0.019). Jaw claudication (66.7% vs. 15.4%, p = 0.027) and decreased pulse of the TA (58.3% vs. 7.7%, p = 0.022) were more in the TAB-positive group than in the TAB-negative. The median C-reactive protein (CRP) level was statistically higher in the TAB-positive group compared to the TAB-negative (37 mg/L vs. 12.6 mg/L, p = 0.039). The univariate logistic regression analysis revealed female gender [OR (95%CI): 2.9 (1.7-181.3), p = 0.016], presence of jaw claudication [OR (95%CI): 2.4 (1.6–75.5), p = 0.015], decreased TA pulse [OR (95%CI): 2.8 (1.6-174.5), p = 0.018], and erythrocyte sedimentation rate (ESR) [OR (95%CI): 0.03 (1.0-1.1), p = 0.049] as factors associated with TAB positivity. Conclusion The rate of TAB positivity was 48%. Older age, female gender, the presence of jaw claudication and decreased pulse of TA, high ESR and CRP values are predictive features of TAB positivity and GCA diagnosis.

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“…This is with reference to the recently published article by Aghdam et al [ 1 ] The authors have suggested that giant cell arteritis could be diagnosed on clinical grounds rather than relying on temporal artery biopsy (TAB). [ 1 ] While we agree with the authors' conclusions, it also needs a pointer that around 25% of patients of giant cell arteritis (GCA) can present with visual loss alone due to arteritic anterior ischemic optic neuropathy (AAION). [ 2 ] Patients who do not comply for proper visual acuity assessment due to old age or an underlying neurocognitive disorder may lead to a delay in diagnosis of AAION.…”

Section: Dear Editormentioning

confidence: 99%

Letter – Noninvasive Markers of Arteritic Anterior Ischemic Optic Neuropathy in Giant Cell Arteritis

Bajpai

Madan

Rana

2022

JOVR

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Temporal Artery Biopsy for Diagnosing Giant Cell Arteritis: A Ten-year Review

Cited by 16 publications

References 31 publications

The Adequate Number of Histopathology Cross-sections of Temporal Artery Biopsy in Establishing the Diagnosis of Giant Cell Arteritis

The Adequate Number of Histopathology Cross-sections of Temporal Artery Biopsy in Establishing the Diagnosis of Giant Cell Arteritis

Giant Cell (Temporal) Arteritis: The Rate and Clinical Predictors of Histopathological Diagnosis

Letter – Noninvasive Markers of Arteritic Anterior Ischemic Optic Neuropathy in Giant Cell Arteritis

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