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[Diagnostic delay in Horton's disease. Analysis of the diagnostic delay based on a retrospective study of 130 cases]
E Kelkel1, F Sarrot-Reynauld, C Dussud
1Service de Médecine Interne, Grenoble.
Insights
Delayed diagnosis of temporal arteritis (Horton
Area of Science:
- Rheumatology
- Ophthalmology
- Vascular Medicine
Context:
- Temporal arteritis (Horton's disease) is a serious condition affecting the elderly.
- Ophthalmic complications, including blindness, are a significant risk.
- Early diagnosis is crucial for preventing vision loss.
Purpose:
- To investigate the relationship between diagnostic delay and ophthalmic complications in temporal arteritis.
- To assess the frequency of delayed diagnosis in a cohort of patients.
- To highlight the impact of delayed diagnosis on patient outcomes.
Summary:
- A retrospective study of 130 patients revealed a significant delay in diagnosing temporal arteritis.
- Over half of patients experienced diagnostic delays exceeding 3 months.
- Delayed diagnosis, particularly between 2-6 months, significantly increased the risk of ophthalmic lesions and blindness.
Impact:
- Confirms that temporal arteritis is often diagnosed late by clinicians.
- Suggests that earlier diagnosis could prevent blindness in many cases.
- Emphasizes the need for increased awareness and prompt diagnosis to mitigate severe visual impairment.
Abstract:
Temporal arteritis (Horton's disease) is a multifocal granulomatous arteritis which affects elderly people. Its prognosis depends upon the risk of blindness. In a retrospective study of 130 patients we paid special attention to the delay in diagnosis and its relation to the occurrence of ophthalmic complications. In 73 patients (56.2%), this delay exceeded 3 months and reached more than one year in 22 of them. It was not influenced by age or sex. In requests for admission, the diagnosis of temporal arteritis was suggested in only 28 of the 130 cases; 17.7% of the patients were blind. There was a significant increase in the occurrence of ophthalmic lesions when the diagnosis was delayed by 2 to 6 months. In 6 cases, blindness had been preceded by transient amaurosis. These findings confirm that temporal arteritis is belatedly diagnosed by practitioners and that blindness could be avoided by an earlier diagnosis.