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AB0551 The impact of temporal artery biopsy on diagnosis of giant cell arteritis in clinical practice
  1. E Kaltsonoudis1,
  2. D Kirochristos2,
  3. A Bai-Papoudou3,
  4. P Voulgari3,
  5. AA Drosos3
  1. 1Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina
  2. 2Department of Surgery, University Hospitasl of Ioannina, Department of Surgery
  3. 3Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Medical School, University of Ioannina, Ioannina, Greece

Abstract

Background Temporal artery biopsy (TAB) is the current gold standard for diagnosis of giant cell arteritis (GCA). Clinical manifestations of GCA include cranial symptoms, features of polymyalgia rheumatica (PMR), fever of unknown origin (FUO) and large vessel involvement, following by elevation of C- reactive protein (CRP) and erythrocyte sedimentation rate (ESR). In these patients TAB confirms diagnosis.

Objectives In the current study the impact of TAB on diagnosis of GCA in a large number of patients is presented.

Methods 245 patients who had undergo TAB were evaluated. All patients were more than 50 years old and were admitted in a tertiary University Hospital during the period 2006–2016. More specifically 164 were admitted in the division of internal medicine (DIM), 53 in the rheumatology clinic (RC), 6 in the eye clinic (EC) and 3 in the neurology clinic (NC). All the clinical and laboratory data were recorded and analyzed appropriately.

Results The mean age of the patients was 68,6±5,6 year and 61,5% were women. 49/245 patients had positive TAB (21,17%). More specifically 5/6 positive TAB (83,3%) were ordered by the EC with signs of visual disturbances, mainly visual loss, diplopia and headache. 12/56 positive TAB (22,6%) were ordered by the RC with clinical features of headache and PMR. 31/164 (18,9%) with positive TAB were ordered by DIM with clinical signs of PMR, FUO and anemia of chronic disease and finally 1/3 with positive TAB (33,3) were ordered by the NC with clinical features of severe headache. All patients with positive TAB had elevated levels of CRP and ESR.

Conclusions In elderly patients with cranial symptoms, visual disturbances, PMR, FUO and raised acute phase reactants, the possibility of GCA is very high and TAB is necessary to confirm diagnosis.

Disclosure of Interest None declared

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