Document Detail


Diagnostic value of the history and examination in giant cell arteritis: a clinical pathological study of 81 temporal artery biopsies.
MedLine Citation:
PMID:  3230565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To determine the value of the history and examination in predicting a temporal artery biopsy result, 81 temporal artery biopsies between 1974-1980 were studied. Each biopsy was scored blindly and independently by 2 pathologists and correlated with clinical data and the indications for biopsy at the time of the biopsy. Thirteen biopsies had giant cells and were considered positive, 8 had mononuclear inflammatory cells in the wall (7 cases) or healed arteritis (1 case) and were considered probable, and 60 were negative. In patients with an elevated sedimentation rate, the presence of a sign (tenderness or abnormal temporal artery), or a symptom (visual change or headache) predicted 18 of 21 (86%) positive-probable biopsies, but misclassified 32 of 60 negative biopsies. Attempts to derive a clinical decision rule with improved specificity resulted in unacceptably low sensitivity (missing 5 of 21 positive-probable biopsies). A minimum 5-year followup showed that those patients treated with steroids had a 6-fold increase in fractures and a 4-fold increase in cataracts.
Authors:
C Robb-Nicholson; R W Chang; S Anderson; W N Roberts; J Longtine; J Corson; M Larson; D George; J Green; G Bryant
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  15     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  1988 Dec 
Date Detail:
Created Date:  1989-04-20     Completed Date:  1989-04-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  1793-6     Citation Subset:  IM    
Affiliation:
Departments of Rheumatology/Immunology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biopsy
Female
Follow-Up Studies
Giant Cell Arteritis / diagnosis,  drug therapy,  pathology*
Humans
Male
Middle Aged
Polymyalgia Rheumatica / pathology
Predictive Value of Tests
Prednisone / therapeutic use
Temporal Arteries / pathology*
Grant Support
ID/Acronym/Agency:
AM20580/AM/NIADDK NIH HHS; RR05569/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
53-03-2/Prednisone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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