Background: Giant cell arteritis, or temporal arteritis, is a disease usually affecting those greater than fifty years of age and presents with headache, scalp tenderness, jaw claudication, ear pain, fever, malaise, anorexia and weight loss. Complications include blindness, ischemic viscera and stroke. Often temporal artery biopsy or FDG-PET scan is required to confirm vessel wall inflammation. The importance of early diagnosis and treatment is essential to prevent irreversible vision loss. An accurate diagnosis is important to minimise complications associated with long-term prednisone use including infection, fracture risk and increased cardiovascular risk. Additionally, in Australia to obtain access to 12-months of immunomodulation with Actemra (Tocilizumab), patients must either have a positive temporal artery biopsy or positive FDG-PET with raised inflammatory markers. Patients suspected with temporal arteritis at Wollongong Hospital under the care of the Rheumatology undergo bilateral temporal artery biopsies, 5cm in length. The purpose of this study is to determine the concordance rate between biopsies and to determine how many patients who had bilateral negative temporal artery biopsies later had confirmed temporal arteritis confirmed clinically or through FDG-PET.
Aim:
Methods: Retrospective review of all patients who have had positive bilateral temporal artery biopsies over the last 20 years and are known to a Rheumatologist. This will be compared to a randomly selected matched control group who have had negative bilateral negative temporal artery biopsies. Patients who had a positive unilateral temporal artery biopsy were also included but as a separate group as this is currently the standard of care. All specimens included in the study will be re-reviewed by pathologists to determine the concordance rate. Patients who have had positive TAB will be reviewed to see if a PET scan was also performed. Other data which will also be collected including steroid dose (converted to equivalent oral prednisone dose) prior to biopsy, the delay between symptom onset and biopsy, cardiovascular risk factors concurrent rheumatological diagnoses especially polymyalgia rheumatica the average length of biopsy and demographic data. Additionally, data will be collected on whether there were any cranial localizing signs prior to biopsy.
Results: To be presented
Conclusion: To be presented