Does preoperative steroid treatment affect the histology in giant cell (cranial) arteritis?

J Clin Pathol. 2012 Dec;65(12):1138-40. doi: 10.1136/jclinpath-2012-200870. Epub 2012 Jul 26.

Abstract

Introduction: Giant cell arteritis (GCA) has been successfully treated with steroids for many years and temporal artery biopsy (TAB) is regarded as the gold standard diagnostic test. The primary aim of this study was to determine whether steroid pretreatment abrogates histological features of GCA reducing diagnostic return, as suspected on the basis of anecdotal evidence. This impacts upon patients suspected of having GCA and the need for prompt treatment balanced with the diagnostic need for TAB.

Methods: A 6-year single-centre retrospective study of biopsies (2005-2011) was performed with interrogation of the medical notes for information regarding steroid use. The null hypothesis considered there was no association between steroid use and biopsy outcome.

Results: No significant difference was found between steroid use and biopsy outcome, with biopsies still producing positive results after weeks of steroid treatment.

Conclusions: TAB is still useful in the diagnosis of GCA, even after commencing steroid treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Female
  • Giant Cell Arteritis / drug therapy
  • Giant Cell Arteritis / pathology*
  • Glucocorticoids / pharmacology
  • Glucocorticoids / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Temporal Arteries / drug effects
  • Temporal Arteries / pathology*

Substances

  • Glucocorticoids