Journal article
Giant Cell Arteritis: Validity and Reliability of Various Diagnostic Criteria
American journal of ophthalmology, Vol.123(3), pp.285-296
03/1997
DOI: 10.1016/S0002-9394(14)70123-0
PMID: 9063237
Abstract
To ascertain the validity, reliability, sensitivity, and specificity of various signs and symptoms of and diagnostic tests for early diagnosis of giant cell arteritis.
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.
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).
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%).
Details
- Title: Subtitle
- Giant Cell Arteritis: Validity and Reliability of Various Diagnostic Criteria
- Creators
- SOHAN SINGH HAYREH - Departments of Ophthalmology, College of Medicine, University of Iowa, Iowa City, IowaPATRICIA A PODHAJSKY - Departments of Ophthalmology, College of Medicine, University of Iowa, Iowa City, IowaREMA RAMAN - Preventive Medicine and Environmental Health (Division of Biostatistics), College of Medicine, University of Iowa, Iowa City, IowaBRIDGET ZIMMERMAN - Preventive Medicine and Environmental Health (Division of Biostatistics), College of Medicine, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- American journal of ophthalmology, Vol.123(3), pp.285-296
- Publisher
- Elsevier Inc
- DOI
- 10.1016/S0002-9394(14)70123-0
- PMID
- 9063237
- ISSN
- 0002-9394
- eISSN
- 1879-1891
- Language
- English
- Date published
- 03/1997
- Academic Unit
- Biostatistics; Ophthalmology and Visual Sciences
- Record Identifier
- 9983997356102771
Metrics
23 Record Views