To the Editor We read with interest the study by De Lott et al,1 but we believe that further discussion is justified. It should be emphasized that the diagnosis of giant cell arteritis (GCA) is based on the combination of clinical picture, laboratory test results (C-reactive protein level [CRP], erythrocyte sedimentation rate [ESR], and platelet count), and histopathological findings.2 Because treatment with corticosteroids must be started as soon as the diagnosis is suspected, temporal artery biopsy (TAB) is usually performed at or after the induction of therapy. In many cases, a positive biopsy result is helpful not just to confirm the diagnosis made on the basis of clinical picture and laboratory tests but also to justify long-term steroid use in patients with a high chance of immunosuppressive-related morbidity. Limiting the evaluation of patients with GCA to clinical and laboratory parameters, even those applied to a statistical model, may result in false-negative results and/or undertreatment of a potentially blinding disease.
Grzybowski A, Stacy RC. Temporal Artery Biopsy in Giant Cell Arteritis. JAMA Ophthalmol. 2015;133(10):1220. doi:10.1001/jamaophthalmol.2015.2552