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Published on: October 22, 2014
Plasma viscosity in giant cell arteritis as a predictor of disease activity
M Gudmundsson1, E Nordborg, B A Bengtsson
1Department of Rheumatology, Sahlgren University Hospital, Gothenburg University, Sweden.
Insights
Plasma viscosity is a superior marker to erythrocyte sedimentation rate (ESR) for monitoring giant cell arteritis (GCA) treatment and predicting disease flares. This study highlights its clinical utility in managing GCA patients on prednisolone.
Area of Science:
- Rheumatology
- Clinical Immunology
- Internal Medicine
Background:
- Giant cell arteritis (GCA) is a systemic vasculitis requiring long-term management.
- Standardized prednisolone treatment is common for GCA.
- Monitoring disease activity and predicting flares are crucial for effective GCA management.
Purpose of the Study:
- To compare plasma viscosity, ESR, CRP, and fibrinogen in GCA patients.
- To evaluate the utility of these markers in predicting flare-ups.
- To assess the effectiveness of plasma viscosity in clinical monitoring of GCA treatment.
Main Methods:
- Follow-up of 31 GCA patients on prednisolone for one year.
- Analysis of plasma viscosity, ESR, CRP, and fibrinogen levels.
- Correlation of laboratory variables with clinical findings and disease flares.
Main Results:
- All patients showed elevated plasma viscosity and ESR at diagnosis.
- CRP normalized faster than ESR, plasma viscosity, and fibrinogen.
- Plasma viscosity and ESR correlated closely with clinical findings and predicted flares.
- Plasma viscosity demonstrated advantages over ESR in predicting flares and monitoring treatment.
Conclusions:
- Plasma viscosity is a valuable tool for monitoring GCA activity.
- Plasma viscosity offers superior predictive capabilities for flare-ups compared to ESR.
- Plasma viscosity aids in the clinical management of GCA patients receiving glucocorticoids.
Abstract:
Thirty one patients with giant cell arteritis (GCA) receiving standardised prednisolone treatment were followed up for one year with analyses of plasma viscosity, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), and fibrinogen concentration. On the day of diagnosis all patients had an increased plasma viscosity and ESR, whereas the concentration of CRP was normal in three patients and fibrinogen concentration and haptoglobin values were normal in one patient. IgG levels were increased in two patients. Plasma viscosity correlated significantly with the ESR, IgG level, and fibrinogen concentration. Laboratory variables in subgroups of patients with GCA proved by biopsy were not different from the whole group of patients with GCA. The follow up showed that CRP normalised faster than the ESR, plasma viscosity, and fibrinogen concentration. Plasma viscosity and the ESR paralleled clinical findings more closely and predicted flare ups better than the other variables. Plasma viscosity had advantages over the ESR for predicting flare ups and in the clinical monitoring of treatment with glucocorticoids.
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