Presentation, diagnosis and treatment of giant cell arteritis

Objective: To present patients with giant cell arteritis (GCA) in our centre over a 10 year period in order to confirm current understanding of giant cell arteritis (GCA) and observe any possible specifities in our cohort. Patients and Methods: In this retrospective study all patients diagnosed with GCA in the Clinical Hospital Centre Rijeka from 1 Jan 2011 to 31 Dec 2021 were included. Data were collected on disease presentation and diagnostic workup at the initial exam, and treatment. Results: A total of 51 patients were included in the study, of which 72.55% patients were female, and 72.55% were over 70. Of 50 patients with available data in medical documentation, 8 (16.00%) had systemic disease (S-GCA), while the rest had cranial disease (C-GCA). Headache, considered also a pathognomonic sign, was the most common initial symptom (88.00% in whole cohort, or 97.62% if S-GCA is excluded). Of 49 patients, all had increased erthyrocyte sedimentation rate. Temporal artery biopsy was positive in 12/16 patients with C-GCA, while temporal artery ultrasound was positive in 12/16 patients. Biopsy or ultrasound was not performed in 18 patients, of which 8 were patients with S-GCA, and data were not available for one patient. No patients had both a biopsy and ultrasound performed. All patients were treated with glucocorticoids, 9.80% were also treated with methotrexate, 7.84% with toclizumab, and one with both methotrexate and azathioprine. Conclusion: These results are comparable to other centres in Croatia and at least one centre abroad.
Cilj: Prikazati bolesnike s GCA u našem centru tijekom 10-godišnjeg razdoblja kako bi se potvrdila trenutna saznanja o arteritisu divovskih stanica (GCA) i uočile eventualne specifičnosti naše kohorte. Ispitanici i metode: U retrospektivnu studiju uključeni su svi ispitanici s dijagnosticiranim GCA u Kliničkom bolničkom centru Rijeka od 1. siječnja 2011. do 31. prosinca 2021. Prikupljeni su podatci o njihovoj kliničkoj slici te dijagnostičkoj obradi pri prvom kliničkom pregledu te o terapiji. Rezultati: U studiju je uključen 51 ispitanik, od kojih je 72,55 % ženskog spola te je 72,55 % starije od 70 godina. Od 50 ispitanika za koje postoje podatci u dokumentaciji, 8 (16 %) ih je imalo sistemski oblik (S-GCA), a ostali kranijalni (C-GCA). Glavobolja, koja je ujedno patognomonični znak, bila je najčešći inicijalni simptom (88 % za cijelu kohortu, odnosno 97,62 % ako se isključi S-GCA). Od 49 ispitanika za koje imamo podatke, svi imaju ubrzanu sedimentaciju eritrocita. Biopsija temporalne arterije pozitivna je u 12/16 ispitanika s C-GCA, dok je ultrazvuk bio pozitivan također u 12/16 ispitanika. U 18 bolesnika nije rađena ni biopsija ni ultrazvuk, od kojih su 8 bili bolesnici sa S-GCA te o jednom bolesniku nemamo podatake. Niti jednom pacijentu nisu rađeni i biopsija i ultrazvuk. Svi su ispitanici liječeni s glukokortikoidima, 9,80 % ispitanika je uz to liječeno metotreksatom, 7,84 % s tocilizumabom, dok je jedan od ispitanika liječen s metotreksatom i s azatioprinom. Zaključak: Rezultati su usporedivi s dvama centrima u Hrvatskoj i najmanje jednim inozemnim centrom.