[The value of anamnesis, clinical findings and laboratory parameters in the diagnosis of giant cell arteritis].
Mots clés
Abstrait
In 67 patients with giant cell arteritis (GCA) and 133 control patients, the value of eight clinical parameters and five laboratory findings for the diagnosis of GCA was analyzed. Out of the clinical parameters characteristic for GCA, headaches, visual disturbance, pains of the shoulder or hip regions and fever were of diagnostic value. Of the laboratory findings, only the BSR was of diagnostic value. Inappetence, exhaustion and fatigue, although characteristic of GCA, as well as blood count, alpha-globulins, CRP and alkaline serum phosphatase were of no value in differentiating between GCA and other diseases. Each of the valuable parameters increased the probability of diagnosing GCA from 33% (incidence of GCA in our patients) up to between 48% and 52%. The simultaneous evaluation of several parameters elevated the probability of diagnosing GCA to up to 88%. These results provide a basis for a rational decision in favor of or against biopsy of the temporal artery. In the case of a negative histology, they help to decide in favor of or against long term corticoid therapy.