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An Immunohistopathologic Study to Profile the Folate Receptor Beta Macrophage and Vascular Immune Microenvironment in Giant Cell Arteritis
Published on: February 8, 2019
Temporal artery biopsy for giant cell arteritis: retrospective audit
Habiba Saedon1, Mahmud Saedon, Steve Goodyear
1University Hospitals Coventry and Warwickshire NHS Trust , Coventry , UK ; Birmingham Midland Eye Centre , Birmingham , UK.
JRSM Short Reports
|November 20, 2012
Summary
Temporal artery biopsy (TAB) is feasible for diagnosing giant cell arteritis (GCA). Higher age and elevated erythrocyte sedimentation rate (ESR) indicate GCA, even with negative TAB histology.
Area of Science:
- Rheumatology
- Vascular Medicine
- Histopathology
Background:
- Giant cell arteritis (GCA) is a vasculitis affecting large arteries, primarily the temporal artery.
- Temporal artery biopsy (TAB) is a key diagnostic tool for suspected GCA, aiming to prevent vision loss.
- The diagnostic accuracy and clinical utility of TAB in GCA require ongoing evaluation.
Purpose of the Study:
- To assess the feasibility of temporal artery biopsy (TAB) in patients with suspected giant cell arteritis (GCA).
- To identify clinical and biochemical factors associated with positive TAB histology in GCA.
- To determine the proportion of patients with negative TAB histology who were treated for GCA.
Main Methods:
- Retrospective audit of 153 temporal artery biopsies (TAB) performed between 2005 and 2011 at a teaching hospital.
- Analysis of clinical profiles and biochemical markers (e.g., ESR) in relation to TAB histology.
- Evaluation of steroid therapy initiation in patients with negative TAB findings.
Main Results:
- Of 153 TABs, 32 were positive for GCA and 121 were negative. Nine biopsies were non-arterial.
- Patients with positive TAB histology were older (mean 77.1 vs 69.1 years) and had higher ESR (60 vs 39.8 mm/hr) compared to those with negative histology.
- 61% of patients with negative TAB histology were clinically diagnosed and treated for GCA.
Conclusions:
- Elevated erythrocyte sedimentation rate (ESR) and advanced age are significant indicators for giant cell arteritis (GCA).
- A substantial proportion of patients with histologically negative TAB are clinically diagnosed and managed for GCA.
- Clinical suspicion and inflammatory markers remain crucial in GCA diagnosis, even with non-diagnostic biopsies.
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01:19Assessing Body Temperature - Temporal Artery
Here is a stepwise guide to assessing the body temperature at the temporal artery using a temporal artery thermometer
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
Step 1: Perform hand hygiene and don a fresh pair of gloves to prevent cross-infection and ensure patient safety.
Step 2: Explain the procedure to the patient to establish trust. Clear communication establishes trust with the patient, ensures they understand what to expect, promotes cooperation, and enhances comfort during the procedure.
Step 3: Assess the patient's forehead...
01:14Temperature Measurement Sites
A thermometer measures body temperature. The common sites for measuring body temperature are the oral cavity, axillary region, temporal artery, and skin surface, such as the forehead, abdomen, and axilla. True core body temperature is assessed in the rectum, tympanic membrane, pulmonary artery, esophagus, and urinary bladder.
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...
Oral: When assessing oral temperature, the thermometer tip should be placed under the tongue in the posterior sublingual pocket. It offers accurate readings and can be...