Population-Based Performance of Inflammatory Markers in Giant Cell Arteritis

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2025-03-24 DOI:10.1016/j.ajo.2025.03.022

CLARA M. CASTILLEJO BECERRA , CYNTHIA S. CROWSON , HANNAH E. LANGENFELD , DEENA TAJFIROUZ , KEVIN D. CHODNICKI , MATTHEW J. KOSTER , KENNETH J. WARRINGTON , JOHN J. CHEN

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引用次数: 0

Abstract

Objective

To determine the population-based sensitivities and specificities of various inflammatory markers for the diagnosis of GCA.

Design

Retrospective population-based cross-sectional study.

Participants

Patients who underwent temporal artery biopsy (TAB) from 01/01/1995 through 12/31/2019 in Olmsted County, Minnesota were identified using the Rochester Epidemiology Project (REP). Subjects were categorized as GCA or non-GCA using the 1990 American College of Rheumatology classification criteria for GCA.

Testing

Sensitivity and specificity of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and platelets for a positive GCA diagnosis were calculated.

Main Outcome Measures

GCA diagnosis.

Results

There were 553 patients who underwent TAB, 143 with GCA and 410 without GCA. Median age at time of TAB was 75 years (IQR 69-81) and 372 (67%) were female. Patients with GCA had higher CRP (91.1 vs 49.1 mg/L, P < .001), ESR (66.4 vs 52.0 mm/hr, P < .001), and platelets (370.5 vs 283.1 × 10⁹/L, P < .001) than patients in the non-GCA cohort. Sensitivity was 96% for CRP, 80% for ESR, and 49% for platelets. Specificity was 21% for CRP, 43% for ESR, and 79% for platelets. Combined ESR and CRP had a sensitivity of 77% and specificity of 54% while combined ESR, CRP, and platelets had a sensitivity of 41% and specificity of 84%. Normal inflammatory markers, including ESR, CRP, and platelets, were observed in 2 (3%) GCA patients.

Conclusions

This population-based study evaluated the performance of various inflammatory markers in the diagnosis of GCA. Inflammatory markers are helpful in the diagnosis of GCA, but normal values do not exclude the diagnosis.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.