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Diagnosis of Giant Cell Arteritis Following Negative Temporal Artery Biopsy

Purpose: To identify a patient with a negative temporal artery biopsy who may later be diagnosed with giant cell arteritis based on the study of Breuer et al.

Description

Breuer et al identified clinical factors in patients with a negative temporal artery biopsy who subsequently were diagnosed with giant cell arteritis. This underlies the need to continue monitoring the patient after a negative biopsy. The authors are from Shaare-Zedek Medical Center in Jerusalem.


 

Factors associated with a "false-negative" initial temporal artery biopsy:

(1) older age

(2) presence of a headache

(3) thrombocytosis

 

where:

• Patients with true-negative temporal artery biopsies had an age of 74.8 +/- 8 years while those with false-negative biopsies had an age of 81.7 +/- 6.2 years.

• This data is rearranged: probably true negative if <= 66 years of age, probably false negative if > 83 years and indeterminate for 67 to 83 years.

• The initial assessment for the degree of risk for temporal arteritis would also impact the patient. A patient considered low risk or for whom another cause was found would probably be true negatives.

 


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Specialty

Objective

ICD-10