نقش بيوپسي شريان تمپورال در تشخيص آرتريت سلول ژانت: نتايج يك مطالعه گذشته‌نگر

Temporal Artery Biopsy for Giant Cell Arteritis: A Retrospective Review

هدف: استفاده از بيوپسي شريان تمپورال (TAB) در تشخيص آرتريت سلول ژانت (GCA) و ارزيابي ويژگي‌هاي باليني و آزمايشگاهي بيماران. روش پژوهش: در اين مطالعه گذشته‌نگر، بيماران مشكوك به GCA كه بين سال‌هاي 1387 تا 1396 در يك مركز ارجاعي در ايران تحت TAB قرار گرفته­ بودند، بر اساس معيارهاي بازنگري شده كالج روماتولوژي آمريكا (ACR) در سال 2016 براي ورود به مطالعه انتخاب شدند. يافته‌ها: ميانگين سني 114 بيمار مطالعه شده، 10/17±65/54 سال بود. ميانگين نمره كلي بر اساس معيارهاي بازنگري شده­ 2016، 1/39±4/17 بود، ( 1/28±5/82 براي افراد بيوپسي مثبت و 1/19±3/88 براي افراد بيوپسي منفي) (0/001

Purpose: To investigate the efficacy of temporal artery biopsy (TAB) for the diagnosis of giant cell arteritis (GCA) and to evaluate the clinical and laboratory characteristics of patients. Methods: In this retrospective study, the medical records of suspected GCA patients, who underwent TAB in a tertiary center in Iran between 2008 and 2017, were evaluated. The 2016 American College of Rheumatology (ACR) criteria for early diagnosis of giant cell (temporal) arteritis were considered for each patient for inclusion in this study. Results: A total of 114 patients were included in this study. The mean age was 65.54±10.17 years. The mean overall score based on the 2016 American College of Rheumatology criteria was 4.17±1.39, with 5.82±1.28 for positive biopsies and 3.88±1.19 for negative biopsies (P<0.001) and 17 patients (14.9%) were biopsy-positive. The mean length of the specimen in the biopsy-positive group (18.35 ± 6.9 mm) was higher than the biopsynegative group (15.62 8 8.4 mm), but the difference was not statistically significant (P=0.21). There was no statistically significant difference between the two groups in terms of sex, serum hemoglobin level, platelet count, and erythrocyte sedimentation rate. There was a statistically significant difference between biopsynegative and biopsy-positive groups in terms of patients’ age and the level of C-reactive protein (P<001 and P=0.012, respectively). Conclusion: According to a large number of negative TAB results, avoiding unnecessary biopsies could lower the workload and improve medical services. It is recommended that GCA be diagnosed based on clinical suspicion and laboratory results.