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Article
August 1983

The Clinical Value of Negative Temporal Artery Biopsy Specimens

Author Affiliations

From the Eye Pathology Laboratory, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston. Dr Hedges is now with the New England Medical Center, Tufts University School of Medicine, Boston. Dr Hedges was a Heed Ophthalmic Fellow during this investigation.

Arch Ophthalmol. 1983;101(8):1251-1254. doi:10.1001/archopht.1983.01040020253019
Abstract

• The clinical course of patients with signs and symptoms suggestive of temporal arteritis but with negative temporal artery biopsy specimens was evaluated. Ninety-one patients undergoing a biopsy formed the basis of this study. Of these, 63 patients had no evidence of arteritis on biopsy, and 28 patients had biopsy specimens showing granulomatous inflammation. False-negative findings from biopsy specimens occurred in 5% of patients who had the disease. Cancer was the final diagnosis in 21% of patients with negative biopsy specimens v 3% of patients with temporal arteritis. Various chronic systemic inflammatory diseases were found in 16% of patients with negative biopsy specimens, while none of the patients with temporal arteritis had additional systemic inflammatory diseases. Patients with proven arteritis were notably older and had higher ESRs than patients without the disease. However, no laboratory test or frequently observed symptom or sign noted on initial examination, considered alone or in combination with other findings, had diagnostic sensitivity or specificity as high as temporal artery biopsy.

References
1.
Albert DM, Ruchman MC, Keltner JL:  Skip areas in temporal arteritis . Arch Ophthalmol 1976;94:2072-2077.Article
2.
Klein RG, Campbell RJ, Hunder GG, et al:  Skip lesions in temporal arteritis . Mayo Clin Proc 1976;51:504-510.
3.
Wagener HP, Hollenhorst RW:  The ocular lesions of temporal arteritis . Am J Ophthalmol 1958;45:617-630.
4.
Hollenhorst RW, Brown JR, Wagener HP, et al:  Neurologic aspects of temporal arteritis . Neurology 1960;10:490-498.Article
5.
Fauchald P, Rygvold O, Oystese B:  Temporal arteritis and polymyalgia rheumatica: Clinical and biopsy findings . Ann Intern Med 1972;77:845-852.Article
6.
Ainsworth RW, Gresham GA, Balmforth GV:  Pathological changes in temporal arteries removed from unselected cadavers . J Clin Pathol 1961;14:115-119.Article
7.
Townes DE, Blodi FC:  The diagnostic value of temporal artery biopsy . Trans Am Ophthal Soc 1968;66:33-44.
8.
Lie JF, Brown AL, Carter ET:  Spectrum of aging changes in temporal arteritis . Arch Pathol 1970;90:278-285.
9.
Cullen JF:  Occult temporal arteritis . Br J Ophthalmol 1967;51:513-525.Article
10.
Hamilton CR, Shelley WM, Tumulty PA:  Giant cell arteritis: Including temporal arteritis and polymyalgia rheumatica . Medicine 1971;50:1-27.Article
11.
Huston KA, Hunder GG, Lie JT, et al:  Temporal arteritis: A 25-year epidemiologic, clinical, and pathologic study . Ann Intern Med 1978;88:162-167.Article
12.
Healey LA, Wilske KR:  Presentation of occult giant cell arteritis . Arthritis Rheum 1980;23:641-643.Article
13.
Boghen DR, Glaser JS:  Ischemic optic neuropathy: The clinical profile and natural history . Brain 1975;98:689-908.Article
14.
Fisher CM, in discussion, Schlezinger N, Schatz NJ:  Giant cell arteritis (temporal arteritis) . Trans Am Neurol Assoc Soc 1971;96:12-15.
15.
Cohen DN:  Temporal arteritis: Improvement in visual prognosis and management with repeat biopsies . Trans Am Acad Ophthalmol Otolaryngol 1973;77:74-85.
16.
Sorensen PS, Lorenzen IB:  Giant-cell arteritis, temporal arteritis and polymyalgia rheumatica . Acta Med Scand 1977;201:207-213.Article
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