Cargando…

Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?

Giant cell arteritis (GCA) is an ophthalmological emergency that can be difficult to diagnose and prompt treatment is vital. We investigated the sequential diagnostic value for patients with suspected GCA using three biochemical measures as they arrive to the clinician: first, platelet count, then C...

Descripción completa

Detalles Bibliográficos
Autores principales: Hansen, Michael S., Klefter, Oliver N., Terslev, Lene, Jensen, Mads R., Brittain, Jane M., Døhn, Uffe M., Faber, Carsten, Heegaard, Steffen, Wiencke, Anne K., Subhi, Yousif, Hamann, Steffen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058337/
https://www.ncbi.nlm.nih.gov/pubmed/36983848
http://dx.doi.org/10.3390/life13030693
_version_ 1785016606826430464
author Hansen, Michael S.
Klefter, Oliver N.
Terslev, Lene
Jensen, Mads R.
Brittain, Jane M.
Døhn, Uffe M.
Faber, Carsten
Heegaard, Steffen
Wiencke, Anne K.
Subhi, Yousif
Hamann, Steffen
author_facet Hansen, Michael S.
Klefter, Oliver N.
Terslev, Lene
Jensen, Mads R.
Brittain, Jane M.
Døhn, Uffe M.
Faber, Carsten
Heegaard, Steffen
Wiencke, Anne K.
Subhi, Yousif
Hamann, Steffen
author_sort Hansen, Michael S.
collection PubMed
description Giant cell arteritis (GCA) is an ophthalmological emergency that can be difficult to diagnose and prompt treatment is vital. We investigated the sequential diagnostic value for patients with suspected GCA using three biochemical measures as they arrive to the clinician: first, platelet count, then C-reactive protein (CRP), and lastly, erythrocyte sedimentation rate (ESR). This retrospective cross-sectional study of consecutive patients with suspected GCA investigated platelet count, CRP, and ESR using diagnostic test accuracy statistics and odds ratios (ORs) in a sequential fashion. The diagnosis was established by experts at follow-up, considering clinical findings and tests including temporal artery biopsy. A total of 94 patients were included, of which 37 (40%) were diagnosed with GCA. Compared with those without GCA, patients with GCA had a higher platelet count (p < 0.001), CRP (p < 0.001), and ESR (p < 0.001). Platelet count demonstrated a low sensitivity (38%) and high specificity (88%); CRP, a high sensitivity (86%) and low specificity (56%); routine ESR, a high sensitivity (89%) and low specificity (47%); and age-adjusted ESR, a moderate sensitivity (65%) and moderate specificity (65%). Sequential analysis revealed that ESR did not provide additional value in evaluating risk of GCA. Initial biochemical evaluation can be based on platelet count and CRP, without waiting for ESR, which allows faster initial decision-making in GCA.
format Online
Article
Text
id pubmed-10058337
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-100583372023-03-30 Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis? Hansen, Michael S. Klefter, Oliver N. Terslev, Lene Jensen, Mads R. Brittain, Jane M. Døhn, Uffe M. Faber, Carsten Heegaard, Steffen Wiencke, Anne K. Subhi, Yousif Hamann, Steffen Life (Basel) Article Giant cell arteritis (GCA) is an ophthalmological emergency that can be difficult to diagnose and prompt treatment is vital. We investigated the sequential diagnostic value for patients with suspected GCA using three biochemical measures as they arrive to the clinician: first, platelet count, then C-reactive protein (CRP), and lastly, erythrocyte sedimentation rate (ESR). This retrospective cross-sectional study of consecutive patients with suspected GCA investigated platelet count, CRP, and ESR using diagnostic test accuracy statistics and odds ratios (ORs) in a sequential fashion. The diagnosis was established by experts at follow-up, considering clinical findings and tests including temporal artery biopsy. A total of 94 patients were included, of which 37 (40%) were diagnosed with GCA. Compared with those without GCA, patients with GCA had a higher platelet count (p < 0.001), CRP (p < 0.001), and ESR (p < 0.001). Platelet count demonstrated a low sensitivity (38%) and high specificity (88%); CRP, a high sensitivity (86%) and low specificity (56%); routine ESR, a high sensitivity (89%) and low specificity (47%); and age-adjusted ESR, a moderate sensitivity (65%) and moderate specificity (65%). Sequential analysis revealed that ESR did not provide additional value in evaluating risk of GCA. Initial biochemical evaluation can be based on platelet count and CRP, without waiting for ESR, which allows faster initial decision-making in GCA. MDPI 2023-03-03 /pmc/articles/PMC10058337/ /pubmed/36983848 http://dx.doi.org/10.3390/life13030693 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hansen, Michael S.
Klefter, Oliver N.
Terslev, Lene
Jensen, Mads R.
Brittain, Jane M.
Døhn, Uffe M.
Faber, Carsten
Heegaard, Steffen
Wiencke, Anne K.
Subhi, Yousif
Hamann, Steffen
Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?
title Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?
title_full Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?
title_fullStr Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?
title_full_unstemmed Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?
title_short Is Erythrocyte Sedimentation Rate Necessary for the Initial Diagnosis of Giant Cell Arteritis?
title_sort is erythrocyte sedimentation rate necessary for the initial diagnosis of giant cell arteritis?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058337/
https://www.ncbi.nlm.nih.gov/pubmed/36983848
http://dx.doi.org/10.3390/life13030693
work_keys_str_mv AT hansenmichaels iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT klefterolivern iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT terslevlene iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT jensenmadsr iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT brittainjanem iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT døhnuffem iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT fabercarsten iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT heegaardsteffen iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT wienckeannek iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT subhiyousif iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis
AT hamannsteffen iserythrocytesedimentationratenecessaryfortheinitialdiagnosisofgiantcellarteritis