Titre du document / Document title

Giant cell arteritis : Validity and reliability of various diagnostic criteria

Auteur(s) / Author(s)

SOHAN SINGH HAYREH ⁽¹⁾ ; PODHAJSKY P. A. ⁽¹⁾ ; RAMAN R. ⁽²⁾ ; ZIMMERMAN B. ⁽²⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Ophthalmology, College of Medicine, University of Iowa, Iowa City, Iowa, ETATS-UNIS
⁽²⁾ Department of Preventive Medicine and Environmental Health (Division of Biostatistics), College of Medicine, University of Iowa, Iowa City, Iowa, ETATS-UNIS

Résumé / Abstract

PURPOSE: To ascertain the validity, reliability, sensitivity, and specificity of various signs and symptoms of and diagnostic tests for early diagnosis of giant cell arteritis. METHODS: From 1973 to 1994, we studied 363 patients who had temporal artery biopsy for suspected giant cell arteritis. All patients underwent detailed clinical evaluation and had erythrocyte sedimentation rates determined; since 1985, 223 patients had their C-reactive protein values estimated. Erythrocyte sedimentation rate and C-reactive protein levels were also estimated in 749 and 138 control subjects, respectively. Signs and symptoms of giant cell arteritis, erythrocyte sedimentation rate, and C-reactive protein levels among patients with positive and negative biopsies were compared. RESULTS: Of the 363 patients, temporal artery biopsy was positive in 106 and negative in 257. The odds of a positive biopsy were 9.0 times greater with jaw claudication (P <.0001), 3.4 times greater with neck pain (P =.0085), 2.0 times greater with an erythrocyte sedimentation rate of 47 to 107 mm/hour (P =.0454), 3.2 times greater with C-reactive protein above 2.45 mg/dl (P =.0208), and 2.0 times greater for age 75 years or more (P =.0105). CONCLUSIONS: Clinical criteria most strongly suggestive of giant cell arteritis include jaw claudication, C-reactive protein above 2.45 mg/dl, neck pain, and an erythrocyte sedimentation rate of 47 mm/hour or more, in that order. C-reactive protein was more sensitive (100%) than erythrocyte sedimentation rate (92%) for detection of giant cell arteritis; erythrocyte sedimentation rate combined with C-reactive protein gave the best specificity (97%).

Revue / Journal Title

American journal of ophthalmology   ISSN 0002-9394   CODEN AJOPAA 

Source / Source

1997, vol. 123, n^o3, pp. 285-296 (42 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, New York, NY, ETATS-UNIS  (1884) (Revue)

Mots-clés anglais / English Keywords

Giant cell arteritis ; Symptomatology ; Biological method ; C reactive protein ; Validity ; Reliability ; Human ; Cardiovascular disease ; Vascular disease ; Vasculitis ; Systemic disease ;

Mots-clés français / French Keywords

Horton maladie ; Symptomatologie ; Méthode biologique ; Protéine C réactive ; Validité ; Fiabilité ; Homme ; Appareil circulatoire pathologie ; Vaisseau sanguin pathologie ; Vascularite ; Maladie système ;

Mots-clés espagnols / Spanish Keywords

Hortón enfermedad ; Sintomatología ; Método biológico ; Proteína reactiva ; Validez ; Fiabilidad ; Hombre ; Aparato circulatorio patología ; Vaso sanguíneo patología ; Vasculitis ; Enfermedad sistémica ;

Localisation / Location

INIST-CNRS, Cote INIST : 2012, 35400006358239.0010