Clinical manifestations of temporal arteritis: a report from Israel

To examine the clinical manifestations of 39 patients with temporal (giant cell) arteritis (GCA), allocated during a 10 year period in the largest medical center in Israel.

The patients were included in the analysis if they fulfilled the new American College of Rheumatology Classification Criteria for the diagnosis of GCA. Patients were divided into biopsy-proven (30 patients) and biopsy-negative (9 patients) groups, and their clinical manifestations were compared using Student's t test for comparison of continuous variables, and Fisher's exact test for comparison of proportions.

The most common presenting symptoms of the patients with TA included headache (87% of the biopsy-proven patients), fever (64%), visual abnormalities (41%), and polymyalgia rheumatica (PMR) or weight loss (20% each). Pulmonary involvement occurred in 5 patients. Ten percent of the biopsy-proven patients presented with occult presentation. Analysis of biopsy-proven and biopsy-negative groups revealed the feasibility of making the diagnosis of temporal arteritis on the basis of simple clinical variables, even without a positive biopsy, as the 2 groups of patients had comparable manifestations. However, the biopsy-proven group was older, included more males and presented significantly more with fever, compared to the biopsy-negative patients. Moreover, although not reaching statistical significance, the biopsy-proven patients tended to have more systemic and extracranial symptoms, including pulmonary manifestations.

Compared to a previous report from Israel on patients with temporal arteritis, almost 2 decades ago, our data suggest that the incidence of the disease in Israel has increased, whereas the ethnic distribution has not changed.