Effect of prior steroid treatment on temporal artery biopsy findings in giant cell arteritis. Ray-Chaudhuri N,∗∗Department of Ophthalmology, Clarement Wing, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK. Kiné DA, Tijani SO, Parums DV, Cartlidge N, Strong NP, Dayan MR. Br J Ophthalmol 2002;86:530–532
2002; Elsevier BV; Volume: 134; Issue: 5 Linguagem: Inglês
10.1016/s0002-9394(02)01780-4
ISSN1879-1891
Autores Tópico(s)Cell Adhesion Molecules Research
ResumoThis study examined the effects of corticosteroid treatment on the histopathologic features of temporal artery biopsies in patients with suspected giant cell arteritis. Eleven patients meeting the American College of Rheumatology criteria for diagnosis of giant cell arteritis (GCA) were prospectively studied. The patients underwent temporal artery biopsy within 1 week, at 2 to 3 weeks, or after 4 weeks of corticosteroid treatment. The criteria assessed for a positive biopsy included the presence of giant cells, lymphocytes/histiocytes in the media, replication of the elastic lamina, and intimal thickening. If one or more of these features were absent, healed arteritis or atherosclerosis was considered. Overall, 9 of the 11 (82%) patients had positive biopsies. Six of seven (86%) biopsies performed after 4 or more weeks of corticosteroid treatment were positive. The authors concluded that temporal artery biopsy is useful even several weeks after institution of corticosteroids. Positive biopsies included those with no inflammation, but only intimal hyperplasia and fragmentation of the internal elastic lamina. However, those findings may be found in arteriosclerotic temporal arteries, and are not necessarily diagnostic of temporal arteritis. If one recategorizes cases without inflammation as negative, and if one examines the positive biopsy rate as a function of time of corticosteroid therapy, there is a decrease in positive biopsy rate as a function of time on corticosteroids. Therefore, the best yield would be to perform the biopsy within 4 days of onset of corticosteroid therapy.—Hans E. Grossniklaus
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