Giant cell arteritis and polymyalgia rheumatica: diagnosis and evolution of 90 cases

Journal: Anales De Medicina Interna (Madrid, Spain : 1984)
Published:
Abstract

Objective: To compare the clinical features of giant cell arteritis (GCA) and polymyalgia rheumatic (PMR), and to evaluate the criteria proposed by the American College of Rheumatology in our results.

Methods: A retrospective analysis of 90 patients with GCA (n = 57.55 of whom were diagnosed by biops) and PMR (n = 33) diagnosed over the last 10 years.

Results: Headache was present in 45 patients (78.94%) with GCA and in 7 (21.21%) with PMR (p < 0.001); polymyalgic syndrome was observed in 15 patients (26.31%) with GCA and in 33 (100%) with PMR (p < 0.001); jaw or tongue claudication was observed in 14 patients (24.57%) with GCA and in 2 (6.06%) with PMR (p < 0.05), and visual disturbances were only present in 9 patients (15.79%) with GCA. The erythrocyte sedimentation rate (ESR) was > or = 50 mm/h in 84 patients (93.33%), and > or = 100 mm/h in 43 of them (51.19%). The ESR became normal (20 Pounds mm/h) in less of 8 weeks after the treatment was started in 64 patients (76.19%). At the time of diagnosis, 61 patients (61.67%) had anemia, which was severe (Hb < 10 g/dl) in 17 cases (27.86%). After steroid treatment 43 patients (70.49%) improved their anemia in less of 12 weeks, and 25 of them (58.13%) in less of 8 weeks.

Conclusions: The cranial symptoms were predictive for a positive temporal artery biopsy. The anemia and its quick normalization after steroid treatment can help to the diagnostic.

Authors
A Rivero Puente, J Berasategui Calderón, J Murie Carrillo De Albornoz, M Rivero Marcotegui, F García Bragado Acín