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Identification of Herpes Zoster-Associated Temporal Arteritis Among Cases of Giant Cell Arteritis
Journal article   Open access   Peer reviewed

Identification of Herpes Zoster-Associated Temporal Arteritis Among Cases of Giant Cell Arteritis

Erin M Buckingham, Maria A Foley, Charles Grose, Nasreen A Syed, Morton E Smith, Todd P Margolis, Matthew J Thurtell and Randy Kardon
American journal of ophthalmology, Vol.187, pp.51-60
03/2018
DOI: 10.1016/j.ajo.2017.12.017
PMCID: PMC5866091
PMID: 29294312
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Published (Version of record)CC BY-NC-ND V4.0 Open Access
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https://doi.org/10.1016/j.ajo.2017.12.017View
Published (Version of record)Am J Ophthalmol. 2018 Mar;187:51-60.

Abstract

PURPOSE: To examine whether herpes zoster antigen (also called varicella-zoster virus antigen) was detectable in temporal artery biopsies taken from individuals with giant cell arteritis (GCA). <p>DESIGN: Retrospective comparative case series.</p> <p>METHODS: Sections of formalin-fixed paraffin-embedded temporal arteries were examined first by hematoxylin-eosin (H&E) staining to establish the diagnosis of GCA. Adjacent sections of the same biopsy were then examined by immunohistochemistry, using 2 different monoclonal antibodies against a major antigen of varicella-zoster virus called gE. Pathologic specimens were obtained from patients cared for at the University of Iowa and Washington University in St. Louis ophthalmology clinics.</p> <p>RESULTS: The study included biopsies from 25 patients with symptoms of GCA as well as positive H&E pathology and 25 patients with symptoms compatible with GCA but negative H&E pathology. Among the GCA-positive group, 3 patients had positive staining for herpes zoster antigen. Among the GCA-negative group, herpes zoster antigen was not detected in any biopsy. In both groups of patients, false-positive staining for herpes zoster antigen was detected in the presence of calcifications in the arteries. False-positive staining was also detected on some extra-arterial skeletal muscle and erythrocytes.</p> <p>CONCLUSION: Herpes zoster antigen was detected in 3 of 25 temporal arteries from patients with biopsy-proven GCA. One of the 3 positive cases was noteworthy because the patient had had herpes zoster ophthalmicus diagnosed 3 weeks before the onset of GCA symptoms. False-positive staining for herpes zoster antigen was detected on several temporal artery biopsies.</p>
Immunohistochemistry Ophthalmology Pathology Pediatrics Virology Infectious Disease Medical Pathology Virus Diseases Herpes Zoster Giant cell arteritis herpes zoster ophthalmicus eye infections glycoprotein E, varicella-zoster virus Viral Envelope Proteins

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