Efficacy of unilateral veru bilateral temporal artery biopie for the diagnoi of giant cell arteriti Original Reearch Article

PURPOE: To determine the utility of unilateral veru bilateral temporal artery biopie in detecting the pathologic change of giant cell arteriti. METHOD: We performed a retropective tudy to determine the utility of unilateral veru bilateral temporal artery biopie in detecting the pathologic change of giant cell arteriti. The pathologic report of conecutive temporal artery biopy pecimen received at the Wilmer Ocular Pathology Laboratory over a 28-year period from 1968 to 1996 were reviewed. REULT: Of 908 pecimen examined from 758 patient, 300 pecimen were imultaneou bilateral biopie from 150 patient, 72 pecimen were bilateral equential biopie from 36 patient, and the remaining 536 pecimen were unilateral biopie from 536 patient. Of the 186 patient who had bilateral imultaneou or nonimultaneou biopie, 176 had identical diagnoe on both ide. In four patient, no artery wa obtained on one ide. In each of the remaining ix patient, five of whom had bilateral imultaneou biopie and one of whom had bilateral equential biopie performed 8 day apart, the biopy pecimen from one ide wa interpreted a howing only arterioclerotic change with no evidence of active or healed arteriti, wherea the other pecimen wa interpreted a howing either probable healed arteriti (three pecimen) or poible early arteriti (three cae). In none of the ix patient with differing diagnoe between the two ide wa one ide interpreted a howing definite, active giant cell arteriti. Five of the ix patient were ubequently determined to have giant cell arteriti, baed on a combination of clinical finding, erythrocyte edimentation rate, and repone to treatment with ytemic corticoteroid. CONCLUION: The reult of thi tudy indicate that performing a bilateral imultaneou or equential temporal artery biopy improve the diagnotic yield in at leat 3% of cae of giant cell arteriti, wherea in 97% of cae, the two pecimen how the ame finding. Thu, in patient in whom only one artery can be biopied, there i a high probability of obtaining the correct diagnoi. Neverthele, although the improvement in diagnotic yield of bilateral temporal artery biopie i low, the conequence of both delayed diagnoi and treatment of giant cell arteriti a well a the ue of ytemic corticoteroid in patient who do not have giant cell arteriti are of uch potential everity that conideration hould alway be given to performing bilateral temporal artery biopie in patient upected of having the dieae.