CLINICAL MANIFESTATIONS OF TEMPORAL ARTERITIS - A REPORT FROM ISRAEL

Objective. To examine the clinical manifestations of 39 patients with temporal (giant cell) arteritis (GCA), allocated during a 10 year peri od in the largest medical center in Israel. Methods. The patients were included in the analysis if they fulfilled the new American College o f Rheumatology Classification Criteria for the diagnosis of GCA. Patie nts were divided into biopsy-proven (30 patients) and biopsy-negative (9 patients) groups, and their clinical manifestations were compared u sing Student's t test for comparison of continuous variables, and Fish er's exact test for comparison of proportions. Results. The most commo n presenting symptoms of the patients with TA included headache (87% o f the biopsy-proven patients), fever (64%), visual abnormalities (41%) , and polymyalgia rheumatica (PMR) or weight loss (20% each). Pulmonar y involvement occurred in 5 patients, Ten percent of the biopsy-proven patients presented with occult presentation. Analysis of biopsy-prove n and biopsy-negative groups revealed the feasibility of making the di agnosis of temporal arteritis on the basis of simple clinical variable s, even without a positive biopsy, as the 2 groups of patients had com parable manifestations. However, the biopsy-proven group was older, in cluded more males and presented significantly more with fever, compare d to the biopsy-negative patients. Moreover, although not reaching sta tistical significance, the biopsy-proven patients tended to have more systemic and extracranial symptoms, including pulmonary manifestations . Conclusion. Compared to a previous report from Israel on patients wi th temporal arteritis, almost 2 decades ago, our data suggest that the incidence of the disease in Israel has increased, whereas the ethnic distribution has not changed.