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Article
July 1987

Erythrocyte Sedimentation Rate and Its Relationship to Hematocrit in Giant Cell Arteritis

Author Affiliations

From the Department of Neurology (Dr Jacobson) and the Department of Ophthalmology, Eye and Ear Institute (Dr Slamovits), University of Pittsburgh School of Medicine. Dr Jacobson is now with the Neuro-ophthalmology Unit, Department of Neurology, Marshfield (Wis) Clinic.

Arch Ophthalmol. 1987;105(7):965-967. doi:10.1001/archopht.1987.01060070101037
Abstract

• We separated 24 patients with biopsy-proved giant cell arteritis into three groups based on erythrocyte sedimentation rates (ESRs) at clinical presentation: low, 1 to 40 mm/h; high, 41 to 80 mm/h; and very high, greater than 80 mm/h. The presence of anemia in the very high ESR group compared with the low ESR group was the only statistically identified difference. A linear regression analysis confirmed a high degree of inverse correlation between ESR and hematocrit in the subject population. There was no difference in ischemic ocular complications among the three groups. These findings emphasize that the diagnosis of giant cell arteritis should be made predominantly on clinical suspicion with less reliance on the ESR as a diagnostic criterion. Furthermore, the degree of ESR elevation does not predict which patients are at increased risk for the development of ocular complications. Finally, the ESR may not reliably indicate active disease in patients with normal hematocrit values.

References
1.
Jonasson F, Cullen JF, Elton RA:  Temporal arteritis: A 14-year epidemiological, clinical and prognostic study . Scott Med J 1979;24:111-117.
2.
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
3.
Whitfield AGW, Bateman M,  Trevor Cooke W: Temporal arteritis . Br J Ophthalmol 1963;47:555-566.Article
4.
Beevers DG, Harpur JE, Turk KAD:  Giant cell arteritis: The need for prolonged treatment . J Chronic Dis 1973;26:571-584.Article
5.
Cohen DN:  Temporal arteritis: Improvement in visual prognosis and management with repeat biopsies . Ophthalmology 1973;77:74-84.
6.
Nelson DA:  Basic methodology , in Henry JB, Nelson DA, Washington JA, et al (eds): Clinical Diagnosis and Management by Laboratory Methods . Philadelphia, WB Saunders Co, 1979, vol 1, pp 913-915.
7.
Griffiths RA, Good WR, Watson NP, et al:  Normal erythrocyte sedimentation rate in the elderly . Br Med J 1984;289:724-725.Article
8.
Böttiger LE, Svedberg CA:  Normal erythrocyte sedimentation rate and age . Br Med J 1967;2:85-87.Article
9.
Hynes M, Whitby LEH:  Correction of the sedimentation rate for anaemia . Lancet 1938;2:249-251.Article
10.
Ellis ME, Ralston S:  The ESR in the diagnosis and management of the polymyalgia rheumatica/giant cell arteritis syndrome . Ann Rheum Dis 1983;42:168-170.Article
11.
Kulvin SM:  Erythrocyte sedimentation rates in the elderly . Arch Ophthalmol 1972;88:617-618.Article
12.
Boyd RV, Hoffbrand BI:  Erythrocyte sedimentation rate in elderly hospital in-patients . Br Med J 1966;1:901-902.Article
13.
Gilbertsen VA:  Erythrocyte sedimentation rates in normal patients: A study of 4341 cases . Postgrad Med 1965;38:A44-A52.
14.
Miller A, Green M, Robinson D:  Simple rule for calculating normal erythrocyte sedimentation rate . Br Med J 1983;286:266.Article
15.
Watson P:  Temporal arteritis: Dysphagia and a normal ESR . JAMA 1984;252:1280-1281.Article
16.
Nelson MW, Kunath AM, Welton RC, et al:  Temporal arteritis presenting with jaw claudication and normal erythrocyte sedimentation rate . South Med J 1982;75:1014-1016.Article
17.
Kansu T, Corbett JJ, Savino P, et al:  Giant cell arteritis with normal sedimentation rate . Arch Neurol 1977;34:624-625.Article
18.
Espinoza LR, Espinoza CG:  Temporal arteritis with normal ESR . Arch Intern Med 1980;140:281-282.Article
19.
Gill CR:  Temporal arteritis with normal sedimentation rate . J Ky Med Assoc 1977;75:483-485.
20.
Rouhani F:  Artérite temporale gigantocellulaire à vitesse de sédimentation basse . Schweiz Med Wochenschr 1984;114:54-56.
21.
Säve-Söderbergh J, Malmvall BE, Andersson R, et al:  Giant cell arteritis as a cause of death: Report of nine cases . JAMA 1986;255:493-496.Article
22.
Rosenfeld SI, Kosmorsky GS, Klingele TG, et al:  Treatment of temporal arteritis with ocular involvement . Am J Med 1986;80:143-145.Article
23.
Rynes RI, Mika P, Bartholomew LE:  Development of giant cell (temporal) arteritis in a patient 'adequately' treated for polymyalgia rheumatica . Ann Rheum Dis 1977;36:88-90.Article
24.
Eshaghian J, Goeken JA:  C-reactive protein in giant cell (cranial, temporal) arteritis . Ophthalmology 1980;87:1160-1166.Article
25.
Federici AB, Fox RI, Espinoza LR, et al:  Elevation of von Willebrand factor is independent of erythrocyte sedimentation rate and persists after glucocorticoid treatment in giant cell arteritis . Arthritis Rheum 1984;27:1046-1049.Article
26.
Bull BS, Brecher G:  An evaluation of the relative merits of the Wintrobe and Westergren sedimentation methods, including hematocrit correction . Am J Clin Pathol 1974;62:502-510.
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