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Master Thesis

Caractéristiques cliniques, biologiques et morphologiques des patients suspects d’artérite à cellules géantes à biopsie d’artère temporale « négative »

Abstract : Objectives: to identify differences in clinical and biological features between patients with and without histological features of giant cell arteritis (GCA) on temporal artery biopsy (TAB).  Secondary objectives were (i) to identify the most common differential diagnoses in patients with “negative” TAB and (ii) to describe the 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) positron emission tomography (PET) [FDG-PET] features that were found in patients with “negative” TAB.  Material and methods: this observational single-centre study focussed on patients aged 50 years and over and for whom TAB were performed over a period spanning from January 1st 2014 to August 1st 2020. Subjects suspected of GCA were identified through their electronic pathology records of TAB. Their clinical and biological features as well as imaging findings were extracted from the centre’s electronic medical files along with treatment strategies. Results: of the 128 TAB that were performed over the study period, 65 negative TAB and 39 positive TAB were identified. Female sex (OR= 3.0; CI95% 1.278-6.694; p= 0.015), recent onset headaches (OR= 4.414; CI95% 1.726-10.6; p= 0.002) and painful induration of the temporal artery (OR= 13.88; CI95% 3.65-43.67; p< 0.001) were significantly associated with a positive TAB. GCA was diagnosed in 24/65 cases of negative TAB whereas 12/65 remained unclassified. The most frequent differential diagnosis was systemic vasculitis (n=7). FDG-PET was performed for 45/63 (71%) patients with negative TAB but vascular hypermetabolism was less frequent than in those with positive TAB, with a predilection the descending aorta and aorto-iliac arteries. Conclusion: the histological diagnosis of GCA were more frequently made in female patients with recent onset headaches and painful induration of the temporal artery. The main differential diagnosis was small- and medium-vessel vasculitides for TAB-negative GCA. The latter presented more commonly with aortitis and arteritis of its iliac branches on FDG-PET findings.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03454893
Contributor : Bibliothèque Universitaire de Médecine Nice Connect in order to contact the contributor
Submitted on : Monday, November 29, 2021 - 2:10:23 PM
Last modification on : Tuesday, January 4, 2022 - 3:12:00 AM

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Sonia Saade. Caractéristiques cliniques, biologiques et morphologiques des patients suspects d’artérite à cellules géantes à biopsie d’artère temporale « négative ». Médecine humaine et pathologie. 2021. ⟨dumas-03454893⟩

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