Temporal artery biopsy is not required in all cases of suspected giant cell arteritis.

Temporal artery biopsy (TAB) is performed during the diagnostic workup for giant cell arteritis (GCA), a vasculitis with the potential to cause irreversible blindness or stroke. However, treatment is often started on clinical grounds, and TAB result frequently does not influence patient management. The aim of this study was to assess the need for TAB in cases of suspected GCA. We performed a retrospective review of 185 TABs performed in our institution from 1990 to 2010. Patients were identified through the Hospital In-Patient Enquiry database and theater records. Clinical findings, erythrocyte sedimentation rate, steroid treatment preoperatively, American College of Rheumatology (ACR) criteria for GCA score, biopsy result, and follow-up were recorded. Fifty-eight (31.4%) biopsies were positive for GCA. Presence of jaw claudication (P = 0.001), abnormal fundoscopy (P = 0.001), and raised erythrocyte sedimentation rate (P = 0.001) were significantly associated with GCA. The strongest association with positive biopsy was seen with the prebiopsy ACR score (P < 0.001). Twenty-four (13.7%) patients had undergone biopsy, despite no potential for meeting ACR criteria preoperatively. None of these were positive. Overall, 29 (16.4%) patients had management altered by TAB result. Our results confirm that TAB does not affect management in the majority of patients with suspected GCA. We conclude that TAB has benefit only for patients who score 2 or 3 on the ACR criteria for GCA without biopsy.

Quinn EM ，Kearney DE ，Kelly J ，Keohane C ，Redmond HP ... -  《-》

Quantification of the role of temporal artery biopsy in diagnosing clinically suspected giant cell arteritis.

Varma D ，O'Neill D 《EYE》

Is temporal artery biopsy essential in all cases of suspected giant cell arteritis?

Grossman C ，Barshack I ，Bornstein G ，Ben-Zvi I ... -  《CLINICAL AND EXPERIMENTAL RHEUMATOLOGY》

Steroid use is associated with clinically irrelevant biopsies in patients with suspected giant cell arteritis.

Thomassen I ，den Brok AN ，Konings CJ ，Nienhuijs SW ，van de Poll MC ... -  《-》

Biopsy-negative giant cell arteritis: clinical spectrum and predictive factors for positive temporal artery biopsy.

Gonzalez-Gay MA ，Garcia-Porrua C ，Llorca J ，Gonzalez-Louzao C ，Rodriguez-Ledo P ... -  《SEMINARS IN ARTHRITIS AND RHEUMATISM》