Giant cell arteritis-related aortitis with positive or negative temporal artery biopsy: a French multicentre study

Objective: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB). Method: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a Fre...

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Published in:Scandinavian journal of rheumatology 2019-11, Vol.48 (6), p.474-481
Main Authors: Agard, C, Bonnard, G, Samson, M, de Moreuil, C, Lavigne, C, Jégo, P, Connault, J, Artifoni, M, Le Gallou, T, Landron, C, Roblot, P, Magnant, J, Belizna, C, Maillot, F, Diot, E, Néel, A, Hamidou, M, Espitia, O
Format: Article
Language:English
Subjects:
Aged
Aortitis - diagnostic imaging
Aortitis - mortality
Aortitis - pathology
Biopsy
Female
Giant Cell Arteritis - diagnostic imaging
Giant Cell Arteritis - mortality
Giant Cell Arteritis - pathology
Humans
Male
Middle Aged
Retrospective Studies
Temporal Arteries - pathology
Tomography, X-Ray Computed
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Summary:Objective: To compare the clinical presentation and outcome of giant cell arteritis (GCA)-related aortitis according to the results of temporal artery biopsy (TAB). Method: Patients with GCA-related aortitis diagnosed between 2000 and 2017, who underwent TAB, were retrospectively included from a French multicentre database. They all met at least three American College of Rheumatology criteria for the diagnosis of GCA. Aortitis was defined by aortic wall thickening > 2 mm on computed tomography scan and/or an aortic aneurysm, associated with an inflammatory syndrome. Patients were divided into two groups [positive and negative TAB (TAB+, TAB−)], which were compared regarding aortic imaging characteristics and aortic events, at aortitis diagnosis and during follow-up. Results: We included 56 patients with TAB+ (70%) and 24 with TAB− (30%). At aortitis diagnosis, patients with TAB− were significantly younger than those with TAB+ (67.7 ± 9 vs 72.3 ± 7 years, p = 0.022). Initial clinical signs of GCA, inflammatory parameters, and glucocorticoid therapy were similar in both groups. Coronary artery disease and/or lower limb peripheral arterial disease was more frequent in TAB− patients (25% vs 5.3%, p = 0.018). Aortic wall thickness and type of aortic involvement were not significantly different between groups. Diffuse arterial involvement from the aortic arch was more frequent in TAB− patients (29.1 vs 8.9%, p = 0.03). There were no differences between the groups regarding overall, aneurism-free, relapse-free, and aortic event-free survival. Conclusion: Among patients with GCA-related aortitis, those with TAB− are characterized by younger age and increased frequency of diffuse arterial involvement from the aortic arch compared to those with TAB+, without significant differences in terms of prognosis.
ISSN:0300-9742
1502-7732
DOI:10.1080/03009742.2019.1661011