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A 3 year retrospective case series of temporal arteritis in Portsmouth, United Kingdom
Author(s) -
TRIKHA S,
LOCKWOOD A,
BUCHANAN E,
KIRWAN JF
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.553.x-i1
Subject(s) - medicine , giant cell arteritis , biopsy , incidence (geometry) , erythrocyte sedimentation rate , prednisolone , arteritis , gastroenterology , cohort , retrospective cohort study , surgery , vasculitis , disease , physics , optics
Purpose To investigate the incidence,socioeconomic status and inflammatory markers of patients with biopsy proven Temporal(Giant Cell)Arteritis(GCA)in Portsmouth, United Kingdom. Methods A single‐centre retrospective study assessed patients referred for Temporal Artery biopsy.Serum platelet count,Erythrocyte Sedimentation Rate (ESR)and C‐Reactive Protein(CRP)were analysed. Socioeconomic status was investigated using index of deprivation scores from the national database and compared to a cataract surgery group(control). Patients received high dose oral prednisolone or intravenous methylprednisolone initially,followed by oral prednisolone.Telephone survey follow‐up for biopsy positive patients assessed smoking history and subjective visual improvement following treatment. Results 70% of biopsies were negative. Biopsy positive age adjusted incidence was 29.3/1.93% of cases referred were subsequently diagnosed with GCA on clinical grounds.Mean platelet count was 359.7(B‐ve)vs.438.8(B+ve)(p≤0.001),mean CRP 50.75(B‐ve)vs.98.0(B+ve)(p≤0.001)and mean ESR was 53.9(B‐ve)vs.69.9(B+ve)(p≤0.018). Insignificant differences in socioeconomic status were found in biopsy positive group compared to controls(p=0.112).33% of biopsy positive patients sustained Visual loss, all patients reported unchanged Visual function, irrespective of treatment regime. Conclusion Biopsy +ve GCA was associated with significant elevations in serum platelet count,ESR and CRP levels compared to B‐ve GCA. The incidence in Portsmouth appears higher than other Caucasian populations. GCA appears unrelated to socioeconomic status in this cohort. A large proportion of biopsies were negative or inconclusive – warranting a strict referral pathway to ease pressure on Ophthalmic services.