Diagnostic sensitivity of temporal artery biopsy for giant cell arteritis: a retrospective study

BACKGROUND: Patients with giant cell arteritis (GCA) often present with a range of symptoms including blurred vision, headache, myalgia, and lethargy. The diagnosis of GCA is guided by the American College of Rheumatology (ACR) criteria established in 1990. Despite being considered the gold standard for diagnosing GCA, temporal artery biopsy (TAB) is a procedure that carries potential complications, and its sensitivity can be variable. The aim of this study was to compare the positive TAB rates for GCA at our institution with the rates published in the medical literature.METHODS: A retrospective review was performed for all patients who underwent TAB at our institution between 2015 and 2016.RESULTS: A total of 108 consecutive patients who underwent temporal artery biopsy (TAB) were included. The demographic data revealed that GCA is more prevalent in females (69.4%) compared to males (30.6%), aligning with existing literature. The total positivity rate for TAB at our institution was 32%, which is notably lower than the published reference range of 60-66%.CONCLUSIONS: The lower-than-expected positivity rate and the significant number of false negatives emphasize the need for a multidisciplinary approach and the incorporation of newer imaging modalities.