The Erythrocyte Sedimentation Rate Is Associated with the Development of Visual Complications in Biopsy-Proven Giant Cell Arteritis

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• 作者：Maria J. Lopez-Diaz ; Javier Llorca ; Carlos Gonzalez-Juanatey ; Jose L. Peñ ; a-Sagredo ; Javier Martin ; Miguel A. Gonzalez-Gay
• 关键词：giant cell arteritis ; erythrocyte sedimentation rate ; visual ischemic complications ; predictors of permanent visual loss
• 刊名：Seminars in Arthritis and Rheumatism
• 出版年：2008
• 出版时间：October 2008
• 年：2008
• 卷：38
• 期：2
• 页码：116-123
• 全文大小：134 K

文摘

Objectives

To investigate the potential association between levels of the erythrocyte sedimentation rate (ESR) and specific clinical features of giant cell arteritis (GCA), in particular, visual loss, in a series of consecutive patients diagnosed with GCA at the reference hospital for a well-defined population.

Methods

The case records of all biopsy-proven GCA patients diagnosed at the Department of Medicine of Hospital Xeral-Calde (Lugo, Northwest Spain) between 1981 and 2006 were reviewed. Clinical information and laboratory data including ESR at the time of disease diagnosis were assessed.

Results

Only 10 (3.6 % ) of the 273 patients had ESR <50 mm/h. Significant differences in the frequency of visual ischemic complications according to different levels of ESR were observed (P = 0.01), mainly due to an increased frequency of visual ischemic events in patients with ESR between 70 and 100/h at the time of disease diagnosis. Twenty-five (21 % ) of 120 individuals with ESR values ranging between 70 and 100 mm/h experienced permanent visual loss compared with only 10 (7 % ) of the remaining 153 patients (P = 0.0005; OR: 3.76 [95 % CI: 1.73-8.19]). An ESR between 70 and 100 mm/h was the best predictor of visual ischemic complications (OR = 2.29 [95 % CI: 1.16-4.55]; P = 0.03) and irreversible visual loss (OR = 3.58 [95 % CI: 1.51-8.49]; P = 0.004).

Conclusions

The results from this study show an increased risk of severe ocular complications in biopsy-proven GCA patients presenting with an ESR between 70 and 100 mm/h. Prompt initiation of corticosteroid therapy and close follow-up of these patients is recommended to minimize the risk of irreversible visual loss.