Clinicopathologic Associations in a Large International Cohort of Patients With Giant Cell Arteritis.
Journal
Arthritis care & research
ISSN: 2151-4658
Titre abrégé: Arthritis Care Res (Hoboken)
Pays: United States
ID NLM: 101518086
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
25
11
2020
received:
22
06
2020
accepted:
15
12
2020
pubmed:
19
12
2020
medline:
26
5
2022
entrez:
18
12
2020
Statut:
ppublish
Résumé
In addition to aiding in diagnosis, histopathologic findings from temporal artery biopsy (TAB) specimens in giant cell arteritis (GCA) may be valuable for their associations with clinical features of the disease. This study was undertaken to compare histopathologic findings on TAB with biopsy interpretation and demographic, clinical, and imaging features at time of diagnosis. Patients with a clinical diagnosis of GCA who had a TAB were selected from an international, multicenter observational cohort of vasculitis. Associations between demographic, clinical, radiographic, and histopathologic features were identified using bivariate testing and multivariate regression modeling. Of 705 patients with GCA who underwent TAB, 69% had histopathologic evidence of definite vasculitis. Specific histopathologic findings included the presence of giant cells (51%), fragmentation of the internal elastic lamina (41%), intimal thickening (33%), and predominantly mononuclear leukocyte infiltration (32%). Histopathologic interpretation of definite vasculitis was independently associated with giant cells (odds ratio [OR] 151.8 [95% confidence interval (95% CI) 60.2-551.6]), predominantly mononuclear leukocyte infiltration (OR 11.8 [95% CI 5.9-24.9]), and fragmentation of the internal elastic lamina (OR 3.7 [95% CI 1.9-7.4]). A halo sign on temporal artery ultrasound and luminal damage of large arteries on angiography were significantly associated with presence of giant cells (OR 2.6 [95% CI 1.1-6.5] and OR 2.4 [95% CI 1.1-5.2], respectively). Specific histopathologic findings were associated with older age, but no associations were identified with vision loss or other clinical features. Histopathologic findings in GCA are strongly associated with the clinical diagnosis of GCA but have a limited role in identifying patterns of disease.
Types de publication
Journal Article
Multicenter Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Intramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1013-1018Subventions
Organisme : Medical Research Council
ID : MR/N011775/1
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Organisme : NIAMS NIH HHS
ID : T32-AR-007611-13
Pays : United States
Informations de copyright
© 2020 American College of Rheumatology.
Références
Hunder GG, Bloch DA, Michel BA, Stevens MB, Arend WP, Calabrese LH, et al. The American College of Rheumatology 1990 criteria for the classification of giant cell arteritis. Arthritis Rheum 1990;33:1122-8.
Hellmich B, Agueda A, Monti S, Buttgereit F, de Boysson H, Brouwer E, et al. 2018 update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 2020;79:19-30.
Luqmani R, Lee E, Singh S, Gillett M, Schmidt WA, Bradburn M, et al. The role of ultrasound compared to biopsy of temporal arteries in the diagnosis and treatment of giant cell arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study. Health Technol Assess 2016;20:1-238.
Lie JT. Illustrated histopathologic classification criteria for selected vasculitis syndromes. Arthritis Rheum 1990;33:1074-87.
Chatelain D, Duhaut P, Schmidt J, Loire R, Bosshard S, Guernou M, et al. Pathological features of temporal arteries in patients with giant cell arteritis presenting with permanent visual loss. Ann Rheum Dis 2008;68:84-8.
Breuer GS, Nesher R, Reinus K, Nesher G. Association between histological features in temporal artery biopsies and clinical features of patients with giant cell arteritis. Isr Med Assoc J 2013;15:271-4.
Muratore F, Boiardi L, Cavazza A, Aldigeri R, Pipitone N, Restuccia G, et al. Correlations between histopathological findings and clinical manifestations in biopsy-proven giant cell arteritis. J Autoimmun 2016;69:94-101.
Makkuni D, Bharadwaj A, Wolfe K, Payne S, Hutchings A, Dasgupta B. Is intimal hyperplasia a marker of neuro-ophthalmic complications of giant cell arteritis? Rheumatology (Oxford) 2008;47:488-90.
Cavazza A, Muratore F, Boiardi L, Restuccia G, Pipitone N, Pazzola G, et al. Inflamed temporal artery: histologic findings in 354 biopsies, with clinical correlations. Am J Surg Pathol 2014;38:1360-70.
Muratore F, Boiardi L, Restuccia G, Macchioni P, Pazzola G, Nicolini A, et al. Comparison between colour duplex sonography findings and different histological patterns of temporal artery. Rheumatology (Oxford) 2013;52:2268-74.
Gribbons KB, Ponte C, Craven A, Robson JC, Suppiah R, Luqmani R, et al. Diagnostic assessment strategies and disease subsets in giant cell arteritis: data from an international observational cohort. Arthritis Rheumatol 2020;72:667-76.
Gribbons KB, Ponte C, Carette S, Craven A, Cuthbertson D, Hoffman GS, et al. Patterns of arterial disease in Takayasu arteritis and giant cell arteritis. Arthritis Care Res (Hoboken) 2020:72;1615-24.
Jia L, Couce M, Barnholtz-Sloan JS, Cohen ML. Is all inflammation within temporal artery biopsies temporal arteritis? Hum Pathol 2016;57:17-21.
Imfeld S, Aschwanden M, Rottenburger C, Schegk E, Berger CT, Staub D, et al. [18F]FDG positron emission tomography and ultrasound in the diagnosis of giant cell arteritis: congruent or complementary imaging methods? Rheumatology (Oxford) 2020;59:772-8.
Hernández-Rodríguez J, Murgia G, Villar I, Campo E, Mackie SL, Chakrabarty A, et al. Description and validation of histological patterns and proposal of a dynamic model of inflammatory infiltration in giant-cell arteritis. Medicine (Baltimore) 2016;95:e2368.