Details

Autor(en) / Beteiligte

• Mahr, A.
• Saba, M.
• Kambouchner, M.
• Polivka, M.
• Baudrimont, M.
• Brochériou, I.
• Coste, J.
• Guillevin, L.

Titel

PP16. TEMPORAL ARTERY BIOPSY TO DIAGNOSE GIANT CELL ARTERITIS: THE LONGER, THE BETTER?

Ist Teil von

• Rheumatology (Oxford, England), 2005-07, Vol.44 (suppl-3), p.iii19-iii20

Ort / Verlag

Oxford: Oxford University Press

Erscheinungsjahr

2005

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Background: The optimal temporal artery biopsy (TAB) length yielding high diagnostic sensitivity for giant-cell arteritis (GCA) remains unknown. Methods: We reviewed the histological TAB reports generated from 4 hospital pathology departments during defined periods with respect to demographics, histological findings and formalin-fixed TAB lengths. For bilateral TAB taken either simultaneously or sequentially within a 30-day interval, the individual sample lengths were added. A biopsy was considered positive for GCA based on the presence of a mononuclear cell infiltrate predominating at the media–intima junction or in the media. Results: Among 1821 TAB histological reports reviewed, 287 (15.8%) were excluded because of missing data on the TAB length or birth date, sampling errors and/or age <50 yr. Mean TAB length of the ultimately analyzed 1520 data sets (67.2% females; mean age: 73.1±10.0 yr) was 1.33±0.73 cm. Histological evidence of GCA was found in 223 (14.7%) specimens, among which 164 (73.5%) contained giant cells. Statistical analyses including piecewise logistic regression identified 0.5 cm as the most pertinent TAB length change point in diagnostic sensitivity. Compared to TAB <0.5 cm, the respective odds ratios for positive TAB without and with multinucleated giant cells in samples ≥0.5-cm long were 5.7 (95% CI, 1.4–23.6) and 4.0 (0.97–16.5). Conclusions: These findings suggest that fixed TAB at least 0.5-cm long could be sufficient to make a histological diagnosis of GCA. Although unlikely, the possibility of our results reflecting an indication bias cannot be excluded.