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Temporal artery biopsy for suspected giant cell arteritis: A mini review

Giant cell arteritis (GCA) is a granulomatous inflammation involving medium and large vessels that can lead to serious clinical manifestations associated with tissue ischemia. Temporal artery biopsy (TAB) is currently the gold standard method for the diagnosis of GCA, with a specificity of 100% and...

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Autores principales: Jiang, Zhijian, Ji, Huiying, Dong, Jianhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683700/
https://www.ncbi.nlm.nih.gov/pubmed/37787225
http://dx.doi.org/10.4103/IJO.IJO_3163_22
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author Jiang, Zhijian
Ji, Huiying
Dong, Jianhong
author_facet Jiang, Zhijian
Ji, Huiying
Dong, Jianhong
author_sort Jiang, Zhijian
collection PubMed
description Giant cell arteritis (GCA) is a granulomatous inflammation involving medium and large vessels that can lead to serious clinical manifestations associated with tissue ischemia. Temporal artery biopsy (TAB) is currently the gold standard method for the diagnosis of GCA, with a specificity of 100% and a sensitivity of 77%. However, the false-negative rate for TAB ranges from 9% to 61%. False negatives may be related to the timing of biopsy, the length of specimen, and the existence of “skip lesions.” We reviewed the relevant evidence for methods to improve the sensitivity and reduce the false-negative rate for TAB. To reduce the false-negative rate for TAB, it is recommended to perform TAB within 1 week of starting corticosteroid therapy. Although there is currently no consensus, we suggest that the temporal artery is cut to a length of 20‒30 mm and to prepare serial pathological sections. It is necessary to attach great importance to patients suspected of having GCA, and complete TAB should be performed as soon as possible while starting corticosteroid therapy promptly. We also discuss the clinical value of non-invasive vascular imaging technologies, such as DUS, CTA, MRA, and 18F-FDG-PET/CT, as auxiliary methods for GCA diagnosis that could partially replace TAB.
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spelling pubmed-106837002023-11-30 Temporal artery biopsy for suspected giant cell arteritis: A mini review Jiang, Zhijian Ji, Huiying Dong, Jianhong Indian J Ophthalmol Review Article Giant cell arteritis (GCA) is a granulomatous inflammation involving medium and large vessels that can lead to serious clinical manifestations associated with tissue ischemia. Temporal artery biopsy (TAB) is currently the gold standard method for the diagnosis of GCA, with a specificity of 100% and a sensitivity of 77%. However, the false-negative rate for TAB ranges from 9% to 61%. False negatives may be related to the timing of biopsy, the length of specimen, and the existence of “skip lesions.” We reviewed the relevant evidence for methods to improve the sensitivity and reduce the false-negative rate for TAB. To reduce the false-negative rate for TAB, it is recommended to perform TAB within 1 week of starting corticosteroid therapy. Although there is currently no consensus, we suggest that the temporal artery is cut to a length of 20‒30 mm and to prepare serial pathological sections. It is necessary to attach great importance to patients suspected of having GCA, and complete TAB should be performed as soon as possible while starting corticosteroid therapy promptly. We also discuss the clinical value of non-invasive vascular imaging technologies, such as DUS, CTA, MRA, and 18F-FDG-PET/CT, as auxiliary methods for GCA diagnosis that could partially replace TAB. Wolters Kluwer - Medknow 2023-10 2023-09-29 /pmc/articles/PMC10683700/ /pubmed/37787225 http://dx.doi.org/10.4103/IJO.IJO_3163_22 Text en Copyright: © 2023 Indian Journal of Ophthalmology https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Review Article
Jiang, Zhijian
Ji, Huiying
Dong, Jianhong
Temporal artery biopsy for suspected giant cell arteritis: A mini review
title Temporal artery biopsy for suspected giant cell arteritis: A mini review
title_full Temporal artery biopsy for suspected giant cell arteritis: A mini review
title_fullStr Temporal artery biopsy for suspected giant cell arteritis: A mini review
title_full_unstemmed Temporal artery biopsy for suspected giant cell arteritis: A mini review
title_short Temporal artery biopsy for suspected giant cell arteritis: A mini review
title_sort temporal artery biopsy for suspected giant cell arteritis: a mini review
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683700/
https://www.ncbi.nlm.nih.gov/pubmed/37787225
http://dx.doi.org/10.4103/IJO.IJO_3163_22
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