POS0820 PREDICTIVE VALUE OF OBJECTIVE EXAMINATION OF TA ON POSITIVITY OF TAB IN GIANT CELL ARTERITIS

Autor: G. Germano, P. Macchioni, G. Klinowski, A. Cavazza, L. Boiardi, C. Salvarani
Rok vydání: 2022
Předmět:
Zdroj: Annals of the Rheumatic Diseases. 81:701.1-701
ISSN: 1468-2060
0003-4967
DOI: 10.1136/annrheumdis-2022-eular.5024
Popis: BackgroundPrevious studies have reported the utility of temporal artery examination for the diagnosis of GCA but no data are available on the correlation between clinical examination and the subsequent temporal artery biopsy (TAB) results of the biopsied vessel.ObjectivesEvaluate the predictive value of temporal artery (TA) examination in patients with suspected GCA on the results of TAB of the same vessel.Methods97 pts consecutively seen at our center because of suspected cranial arteritis between 01.01.2015 to 31.12.2021 were enrolled in the study. All patients had complete clinical examination, laboratory investigations (included ESR and CRP determination), clinical examination of the temporal arteries and their frontal and parietal branches for tenderness (P), reduced or absent pulse (R) and thickening (T). All patients underwent arterial ultrasound (US) followed by a TAB of the most US involved frontal branches. The presence of inflammatory infiltrate of the vessel wall or the inflammation of the periadventitial blood vessel were considered positive for the presence of arteritis. The clinical features of the biopsied vessel were compared with the histological results by chi square test and the correspondent OR with 95%CI. Sensitivity, specificity, negative and positive PV, negative and positive LR were calculated for every singular objective abnormalities.Results97 pts entered the study (F 56 (58%), mean age 73 ± 8, biopsy positive 56 (57%). At clinical examination of the biopsied vessel P was reported in 26 cases (27%) of TAB + and 10 (24.4%) in TAB- group (p=0.646, OR 1.24), R in 15 (15.5%) vs 2 (4.9%) (p=0.021, OR 5.69) and T in 16 (28.6%) vs 2 (4.9%) (p=0.003, OR 7.80), anyone (T or P or R) 30 (54.5% vs 11 (26.8%) (p=0.007, OR 3.27), presence of T or R 23 (41.8%) vs 4 (9.8%) (p=0.001, OR 6.65). Sensitivity, specificity, PPV, NPV, PLR, and NLR of any singular objective data and of US examination are reported in Table 1Table 1.SENS, SPEC, PPV, NPV. PLR, NLR, PRETEST probability, POST TEST probability of clinical objective examination and US results FOR TAB POSITIVITYSENSSPECPPVNPVPLRNLRPREPOSTTA EXAMINATIONTENDERNESS (P)0.2860.7560.6150.4371.170.940.570.61REDUCED/ ABSENT PULSE (R)0.2320.9510.8670.4764.760,800.580.87THICKENING (T)0.2860.9510.8890.4945.860.750.570.89ANYONE (P or R or T)0.5450.7320.7320.5452.030.550.570.73R or T0.4180.9020.8510.5364.280.650.570.85USHALO0.8750.6430.6360.8782.450.190.420.64CT+0.8780.6540.6540.8782.540.190.430.65ConclusionClinical examination (in particular reduced pulse and arterial thickening) of the temporal arteries is predictive of histological positivity of the TAB.AcknowledgementsGabriella Di TommasoDisclosure of InterestsNone declared
Databáze: OpenAIRE
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