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The Clinical Importance of the Presence of Giant Cells in Temporal Arteritis
  1. Arthur T. Armstrong, Jr (atarmstrong{at}geisinger.edu)
  1. Geisinger Medical Center, United States
    1. William B. Tyler (wtyler{at}geisinger.edu)
    1. Geisinger Medical Center, United States
      1. G. Craig Wood (cwood{at}geisinger.edu)
      1. Geisinger Medical Center, United States
        1. Thomas M Harrington (tharrington{at}geisinger.edu)
        1. Geisinger Medical Center, United States

          Abstract

          ABSTRACT

          Aims: The clinical significance of giant cells seen on temporal artery biopsy in temporal arteritis is unknown. The goal of our study was to help define the prognostic value of the presence of giant cells in temporal arteritis.

          Methods: We reviewed the clinical course of all patients with biopsy proven temporal arteritis from 1994 to 2004 at our institution. Ninety-two patients were divided into those with giant cells (GC) (n = 76) seen on biopsy and those with no giant cells (NGC) (n = 16). Clinical findings were compared between groups. An additional analysis combined results with a previous study at our institution to compare occurrence of blindness.

          Results: The GC group had a higher proportion of Polymyalgia Rheumatica (PMR) develop (36.8%) compared to the NGC group (12.5%) (p = .059). No significant differences were seen in patient age, sex, sedimentation rate, or presenting symptoms. The length of time treated with corticosteroids and relapse rate was nearly identical for both groups. When combining data with the previous study the GC group 21/109 (19%) developed blindness, while only 2/34 (6%) became blind in the NGC group (p = 0.11).

          Conclusions: The presence of giant cells was not shown to be a significant factor in determining treatment or clinical progression of temporal arteritis. However, our results showed the GC group to have three times the occurrence of blindness and PMR as compared to the NGC group. Although the differences were not significant, this analysis suggests an association with giant cells and more aggressive disease

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