Clinical course and management of a consecutive series of patients with "healed temporal arteritis".
Clinical course and management of a consecutive series of patients with "healed temporal arteritis".
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DOI：
10.3899/jrheum.110317
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发表时间：
2012-02
期刊：
影响因子：
--
通讯作者：
Docken WP
中科院分区：
文献类型：
--
作者：
Lee YC;Padera RF;Noss EH;Fossel AH;Bienfang D;Liang MH;Docken WP
1)描述病理诊断为“愈合性”巨细胞性动脉炎的患者的临床病程和处理方法；2)确定以前发表的关于愈合性动脉炎的组织学描述是否可以确定临床上有更大可能罹患重大动脉炎的患者。对1994至2003年间所有的颞动脉活检报告进行了检查，以诊断为“愈合性动脉炎”。两名风湿科医生提取了医疗记录，介绍了特征、体检结果、共病情况以及治疗和结果的数据。一位对临床数据视而不见的病理学家回顾了所有的标本，并根据已发表的愈合动脉炎的组织学描述重新解释了活检。47名初步病理诊断为愈合性动脉炎的患者被确定。在这些患者中，54%的患者在病理报告中记录了愈合的动脉炎的诊断后，皮质类固醇治疗没有改变。70%的人最终接受了不使用皮质类固醇或中低水平皮质类固醇方案的治疗。使用标准化组织学标准复查活检后，只有32%的初始病例得到确认。确诊为治愈的动脉炎患者更有可能有记录在案的多发性肌痛、风湿性/巨细胞性动脉炎以及在活检前接受类固醇治疗的时间较长的患者。这些患者并不更有可能出现不良后果。在这一系列病例中，治愈的动脉炎的诊断对治疗决定的影响很小。在大多数情况下，当单个病理学家使用统一的组织学标准对活检进行复查时，治愈的动脉炎的初始病理诊断不能得到确认。
1) To describe the clinical course and management of patients with a pathologic diagnosis of “healed” giant cell arteritis; 2) To determine if previously published histological descriptions of healed arteritis can identify patients with a greater likelihood of clinically significant arteritis. All temporal artery biopsy reports between 1994 and 2003 were examined for a diagnosis of “healed arteritis.” Two rheumatologists abstracted the medical record for presenting features, physical findings, co-morbid conditions and data on treatment and outcomes. One pathologist, blinded to the clinical data, reviewed all specimens and re-interpreted the biopsies according to published histological descriptions of healed arteritis. Forty-seven patients with an initial pathologic diagnosis of healed arteritis were identified. In 54% of these patients, corticosteroid therapy did not change after the diagnosis of healed arteritis was documented in the pathology report. Seventy percent were ultimately treated with no corticosteroids or low-moderate corticosteroid regimens. Only 32% of the initial cases were confirmed upon review of the biopsies using standardized histological criteria. Patients with confirmed healed arteritis were more likely to have a documented history of polymyalgia rheumatica/giant cell arteritis and a longer duration of steroid treatment before biopsy. These patients were not more likely to have adverse outcomes. In this case series, the diagnosis of healed arteritis had little impact on treatment decisions. In most cases, the initial pathologic diagnosis of healed arteritis was not confirmed when biopsies were reviewed by a single pathologist using uniform histological criteria.
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影响因子：
3.4
作者：
AINSWORTH, R;BALMFORTH, GV;GRESHAM, GA
通讯作者：
GRESHAM, GA
影响因子：
3.4
作者：
Ezeonyeji, Amara N.;Borg, Frances A.;Dasgupta, Bhaskar
通讯作者：
Dasgupta, Bhaskar
影响因子：
5.6
作者：
ALLSOP, CJ;GALLAGHER, PJ
通讯作者：
GALLAGHER, PJ
影响因子：
39.2
作者：
FAUCHALD, P;RYGVOLD, O;OYSTESE, B
通讯作者：
OYSTESE, B
影响因子：
120.7
作者：
Smetana, GW;Shmerling, RH
通讯作者：
Shmerling, RH