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Abstract：
UNASSIGNED: Temporal artery (TA) biopsy is commonly used for the diagnosis of giant cell arteritis (GCA). However, a positive biopsy is no longer mandatory for diagnosis. This study aims to correlate the histopathological findings of TA biopsies in suspected cases of GCA to the clinical presentation in an ophthalmic tertiary eye care center to draw useful conclusions and advocate the possible implementation of guidelines for TA biopsy.
UNASSIGNED: Data was collected from patients\' medical records including, demographics, clinical data, and histopathological findings and diagnosis. The 2022 American College of Rheumatology/ European Alliance of Associations for Rheumatology (ACR/EULAR) criteria have been used and partially adopted as a guide to compare the variables between TA biopsy-positive and negative groups as well as the TA biopsy-positive group and the group of patients with TA biopsy showing atherosclerosis.
UNASSIGNED: Out of the total 35 patients who underwent a TA biopsy during the period of 23 years, 22.9% of patients had histopathological findings consistent with GCA and 42.9% had TA atherosclerotic changes, while the remaining 34.3% had histologically unremarkable TA. The mean age of all patients was 66 ± 10.9 years. Slightly more than half were females (54.3%) and the remaining were males (45.7%). In the group with positive TA biopsies, the mean age was 71 ± 8.4 years with a higher female predominance (female-to-male ratio of 5:3). The mean diagnostic clinical score used in our study was higher (7.5 ± 2.33) in the GCA-positive group when compared to the other groups with statistical significance (mean of 4.85 ± 2.01 in patients with overall GCA-negative biopsies and 5.13 ± 2.10 in the group with atherosclerosis). Other three clinical variables that were found to be statistically significant in the GCA biopsy-positive group were scalp tenderness, jaw claudication, and optic nerve pallor.
UNASSIGNED: The mean age (71 ± 8.4 years) and the female predominance of GCA in our group of patients with positive TA biopsy (62.5%) was like other reports. In our study 22.9% of performed TA biopsies over the period of the study were positive confirming the diagnosis of GCA on histological exam, which was similar to another report and is considered to be relatively low. The incorporation of increased clinically focused assessments and algorithms, with the aid of the ACR/EULAR criteria, may decrease the frequency of TA biopsies that carries unnecessary cost and risk of procedure-related morbidity. We highly recommend applying the age of ≥ 50 years as an initial criterion for diagnosis, followed by the consideration of the statistically significant clinical features: scalp tenderness, jaw claudication, and optic nerve pallor.
UNASSIGNED: Data was collected from patients\' medical records including, demographics, clinical data, and histopathological findings and diagnosis. The 2022 American College of Rheumatology/ European Alliance of Associations for Rheumatology (ACR/EULAR) criteria have been used and partially adopted as a guide to compare the variables between TA biopsy-positive and negative groups as well as the TA biopsy-positive group and the group of patients with TA biopsy showing atherosclerosis.
UNASSIGNED: Out of the total 35 patients who underwent a TA biopsy during the period of 23 years, 22.9% of patients had histopathological findings consistent with GCA and 42.9% had TA atherosclerotic changes, while the remaining 34.3% had histologically unremarkable TA. The mean age of all patients was 66 ± 10.9 years. Slightly more than half were females (54.3%) and the remaining were males (45.7%). In the group with positive TA biopsies, the mean age was 71 ± 8.4 years with a higher female predominance (female-to-male ratio of 5:3). The mean diagnostic clinical score used in our study was higher (7.5 ± 2.33) in the GCA-positive group when compared to the other groups with statistical significance (mean of 4.85 ± 2.01 in patients with overall GCA-negative biopsies and 5.13 ± 2.10 in the group with atherosclerosis). Other three clinical variables that were found to be statistically significant in the GCA biopsy-positive group were scalp tenderness, jaw claudication, and optic nerve pallor.
UNASSIGNED: The mean age (71 ± 8.4 years) and the female predominance of GCA in our group of patients with positive TA biopsy (62.5%) was like other reports. In our study 22.9% of performed TA biopsies over the period of the study were positive confirming the diagnosis of GCA on histological exam, which was similar to another report and is considered to be relatively low. The incorporation of increased clinically focused assessments and algorithms, with the aid of the ACR/EULAR criteria, may decrease the frequency of TA biopsies that carries unnecessary cost and risk of procedure-related morbidity. We highly recommend applying the age of ≥ 50 years as an initial criterion for diagnosis, followed by the consideration of the statistically significant clinical features: scalp tenderness, jaw claudication, and optic nerve pallor.
摘要：
■颞动脉（TA）活检通常用于诊断巨细胞动脉炎（GCA）。然而,活检阳性不再是诊断的强制性要求.这项研究旨在将可疑GCA病例中TA活检的组织病理学发现与眼科三级眼科护理中心的临床表现相关联，以得出有用的结论并倡导可能实施TA活检指南。
■数据来自患者的医疗记录，包括：人口统计，临床资料,以及组织病理学发现和诊断。2022年美国风湿病学会/欧洲风湿病学协会联盟（ACR/EULAR）标准已被用作并部分采用，以比较TA活检阳性和阴性组以及TA活检阳性组和TA活检显示动脉粥样硬化的患者组之间的变量。
■在23年期间接受TA活检的35例患者中，22.9%的患者有与GCA一致的组织病理学结果，42.9%有TA动脉粥样硬化改变，而其余34.3%的患者在组织学上没有明显的TA。所有患者的平均年龄为66±10.9岁。略多于一半的是女性(54.3%)，其余的是男性(45.7%)。在TA活检阳性的组中，平均年龄为71±8.4岁，女性占比较高（男女比例为5：3）。与其他组相比，我们研究中使用的GCA阳性组的平均诊断临床评分更高（7.5±2.33），具有统计学意义（总体GCA阴性活检患者的平均值为4.85±2.01，动脉粥样硬化组的平均值为5.13±2.10）。在GCA活检阳性组中发现有统计学意义的其他三个临床变量是头皮压痛，颌骨跛行,视神经苍白。
■在本组TA活检阳性的患者中，GCA的平均年龄（71±8.4岁）和女性占主导地位（62.5%）与其他报道一样。在我们的研究中，在研究期间进行的TA活检中有22.9%呈阳性，证实了组织学检查对GCA的诊断。这与另一份报告相似，被认为是相对较低的。纳入更多的临床重点评估和算法，在ACR/EULAR标准的帮助下，可能会降低TA活检的频率，这会带来不必要的成本和手术相关发病率的风险。我们强烈建议将年龄≥50岁作为诊断的初始标准，然后考虑统计学上显著的临床特征：头皮压痛，颌骨跛行,视神经苍白。
■数据来自患者的医疗记录，包括：人口统计，临床资料,以及组织病理学发现和诊断。2022年美国风湿病学会/欧洲风湿病学协会联盟（ACR/EULAR）标准已被用作并部分采用，以比较TA活检阳性和阴性组以及TA活检阳性组和TA活检显示动脉粥样硬化的患者组之间的变量。
■在23年期间接受TA活检的35例患者中，22.9%的患者有与GCA一致的组织病理学结果，42.9%有TA动脉粥样硬化改变，而其余34.3%的患者在组织学上没有明显的TA。所有患者的平均年龄为66±10.9岁。略多于一半的是女性(54.3%)，其余的是男性(45.7%)。在TA活检阳性的组中，平均年龄为71±8.4岁，女性占比较高（男女比例为5：3）。与其他组相比，我们研究中使用的GCA阳性组的平均诊断临床评分更高（7.5±2.33），具有统计学意义（总体GCA阴性活检患者的平均值为4.85±2.01，动脉粥样硬化组的平均值为5.13±2.10）。在GCA活检阳性组中发现有统计学意义的其他三个临床变量是头皮压痛，颌骨跛行,视神经苍白。
■在本组TA活检阳性的患者中，GCA的平均年龄（71±8.4岁）和女性占主导地位（62.5%）与其他报道一样。在我们的研究中，在研究期间进行的TA活检中有22.9%呈阳性，证实了组织学检查对GCA的诊断。这与另一份报告相似，被认为是相对较低的。纳入更多的临床重点评估和算法，在ACR/EULAR标准的帮助下，可能会降低TA活检的频率，这会带来不必要的成本和手术相关发病率的风险。我们强烈建议将年龄≥50岁作为诊断的初始标准，然后考虑统计学上显著的临床特征：头皮压痛，颌骨跛行,视神经苍白。
