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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558

Abstract

BRABYN, Philip; ZYLBERBERG, Ian; MUNOZ-GUERRA, Mario Fernando  and  NAVAL, Luis. Temporal artery biopsy. A 25-year experience. Rev Esp Cirug Oral y Maxilofac [online]. 2018, vol.40, n.4, pp.147-152. ISSN 2173-9161.  http://dx.doi.org/10.1016/j.maxilo.2017.11.002.

Introduction:

Temporal arteritis or giant cell arteritis is the most common systemic inflammatory vasculitis in adults, affecting large and medium-sized vessels, typically braches of the carotid artery. Treatment is with high-dose corticosteroids. A lack of treatment could lead to important consequences, the most serious of which is visual loss due to anterior ischemic neuropathic neuropathy.

Material and methods:

A retrospective revision of the temporal artery biopsies done in our center in the past 25 years was carried; a descriptive and analytic study was done.

Results:

A total of 620 biopsies were done on patients between 1991 and 2016. 18.4% of them were positive. 68.5% of the patients were female, and the average age was 75.8 years. The length of the biopsy and erythrocyte sedimentation rate (ESR) and C-reactive protein levels of the patients biopsied after 2011 (n = 142) were documented. No significant differences were found between the 2 groups (positive and negative biopsies) for any of the 3 variables.

Conclusion:

Temporal artery biopsy is still the gold standard diagnostic test. The variables with the highest predictive value are the increase in ESR levels, and clinical symptoms (visual disturbances and new-onset headache). The time between diagnostic suspicion and biopsy is crucial, in order to confirm the diagnosis and, initiate, adjust or suspend corticosteroid treatment, and prevent irreversible complications.

Keywords : Temporal artery arteritis; Giant cell arteritis; Temporal artery biopsy.

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