GIANT-CELL ARTERITIS IN ICELAND - AN EPIDEMIOLOGIC AND HISTOPATHOLOGIC ANALYSIS
GIANT-CELL ARTERITIS IN ICELAND - AN EPIDEMIOLOGIC AND HISTOPATHOLOGIC ANALYSIS
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DOI：
10.1002/art.1780370705
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发表时间：
1994-07-01
影响因子：
--
通讯作者：
LIE, JT
中科院分区：
文献类型：
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作者：
BALDURSSON, O;STEINSSON, K;LIE, JT
Objective.研究冰岛高加索人群巨细胞（颞）动脉炎（GCA）的发病率、临床和组织病理学特征。所有1984年至1990年诊断的患者均被纳入。本研究的病例确定通过两种方式完成：1）计算机检索所有医院和初级保健诊所以诊断GCA，2）回顾7年期间进行的所有颞动脉活检。确定了133例GCA患者。全部符合1990年美国流变学学会对GCA分类的标准。50岁及以上人群的发病率为27/100 000（女性和男性分别为36/100 000和18/100 000）。临床结果包括：女性平均诊断年龄72.5岁，男性70.3岁，新发头痛63.2%，触诊颞动脉异常43.6%，平均红细胞沉降率88 mm/h，风湿性多肌痛症状48.1%，视力障碍14.3%。在7年期间，共有744例患者接受了颞动脉活检; 16.8%的患者活检结果呈阳性。所有133例诊断为GCA的患者均接受了颞动脉活检; 94%的患者结果呈阳性。活检阳性标本的组织学表现包括99.2%的内弹力膜断裂，65.6%的巨细胞，12%的纤维素样坏死。与以前的流行病学调查相比，这项研究表明，在冰岛活检证实的GCA的发病率很高。
Objective. To investigate the incidence and clinical and histopathologic features of giant cell (temporal) arteritis (GCA) in the Caucasian population of Iceland.Methods. All patients diagnosed between 1984 and 1990 were included. Case ascertainment for the study was done in 2 ways: 1) a computerized search from all hospitals and primary care clinics for the diagnosis of GCA, and 2) a review of all temporal artery biopsies performed during the 7-year period.Results. One hundred thirty-three patients with GCA were identified. All fulfilled the 1990 American College of Rheumatology criteria for the classification of GCA. The incidence rate for the population 50 years and older was 27/100,000 (36/100,000 and 18/100,000 for women and men, respectively). Clinical findings included the following: mean age at diagnosis 72.5 years for women and 70.3 years for men, new headache 63.2%, abnormal temporal artery on palpation 43.6%, mean erythrocyte sedimentation rate 88 mm/hour, symptoms of polymyalgia rheumatica 48.1%, and visual disturbances 14.3%. A total of 744 patients underwent temporal artery biopsy during the 7-year period; 16.8% had a positive biopsy result. All 133 patients with the diagnosis of GCA underwent a temporal artery biopsy; 94% had a positive result. Histopathologic findings from the positive biopsies included a fragmented internal elastic lamina in 99.2%, giant cells in 65.6%, and fibrinoid necrosis in 12%.Conclusion. Compared with previous epidemiologic surveys, this study shows a high incidence of biopsy-proven GCA in Iceland.