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Published on: February 8, 2019
Microscopic haematuria in giant cell arteritis
S Vanderschueren1, I Depoot, D C Knockaert
1General Internal Medicine, University Hospital Leuven, Leuven, Belgium. Steven.Vanderschueren@uz.kuleuven.ac.be
Clinical Rheumatology
|September 12, 2002
Summary
Microscopic hematuria is common in giant cell arteritis (GCA), often resolving with treatment. Its presence can support a GCA diagnosis, suggesting kidney involvement is usually benign.
Area of Science:
- Nephrology
- Rheumatology
- Internal Medicine
Background:
- Giant cell arteritis (GCA) is typically thought to not affect the kidneys.
- Previous studies suggested a possible link between GCA and microscopic hematuria.
Purpose of the Study:
- To determine the frequency and characteristics of microscopic hematuria in patients with biopsy-proven GCA.
- To compare hematuria rates in GCA patients with polymyalgia rheumatica (PMR) and age-matched controls.
Main Methods:
- Retrospective study of 42 GCA patients, 39 PMR patients, and 62 controls (>60 years).
- Microscopic hematuria defined as >5 RBC/high-power field or >8 RBC/microl.
- Exclusion of patients with pyuria, bacteriuria, or known hematuria disorders.
Main Results:
- Microscopic hematuria present in 47.6% of GCA patients vs. 17.9% (PMR) and 21.0% (controls).
- Urinary RBCs were predominantly dysmorphic in GCA patients.
- Hematuria resolved in 71.4% of GCA patients after corticosteroid initiation.
- No significant differences in symptoms, renal function, or blood pressure between GCA patients with or without hematuria.
Conclusions:
- Microscopic hematuria of renal origin is frequent and generally benign in GCA patients.
- Hematuria in GCA, without elevated blood pressure or renal decline, can support the diagnosis.
- Invasive urologic or nephrologic work-up may not be necessary in typical GCA cases presenting with hematuria.
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