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The incidence of giant cell arteritis in Slovenia

Clinical Rheumatology volume 38, pages 285–290 (2019)Cite this article

Abstract

Giant cell arteritis (GCA) is the most common vasculitis in adults aged ≥ 50 years in Europe. Recently, colour Doppler ultrasonography (CDS) and positron emission tomography-computed tomography (PET/CT) have improved the diagnostic sensitivity. The aim of our study was to determine the incidence of GCA in a well-defined Slovenian region, supported by the temporal artery (TA) biopsy (TAB) or CDS or PET/CT. This prospective study was conducted at the University Medical Centre Ljubljana, the only secondary/tertiary centre in the region, serving a population of 323,297 residents aged ≥ 50 years. Patients with suspected GCA are referred either to the Department of Rheumatology, or in case of severe visual disturbances, to the Department of Ophthalmology. We included all GCA cases diagnosed between 1 January 2012 and 31 December 2017. We diagnosed cranial GCA (c-GCA) using the American College of Rheumatology (ACR) 1990 classification criteria and a positive TAB or TA-CDS. Large vessel GCA (lv-GCA) was diagnosed using CDS or PET/CT. During the 6-year observation, we identified 169 incipient GCA cases (66.3% female, median (IQR) age of 75.1 (68.6–80.0) years). Forty-two (24.8%) patients had lv-GCA, and the others had c-GCA. The estimated annual incidence rates of GCA were overall 8.7 (95% CI 7.5–10.1), c-GCA 6.5 (95% CI 5.5–7.8) and lv-GCA 2.2 (95%CI 1.6–2.9) per 100,000 aged ≥ 50 years. GCA is the most common vasculitis in adults aged ≥ 50 years, with an annual incidence rate of 8.7 per 100,000.

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References

  1. Gonzalez-Gay MA, Vazquez-Rodriguez TR, Lopez-Diaz MJ, Miranda-Filloy JA, Gonzalez-Juanatey C, Martin J, Llorca J (2009) Epidemiology of giant cell arteritis and polymyalgia rheumatica. Arthritis Rheum 61(10):1454–1461. https://doi.org/10.1002/art.24459

    Article  PubMed  Google Scholar 

  2. Pamuk ON, Donmez S, Karahan B, Pamuk GE, Cakir N (2009) Giant cell arteritis and polymyalgia rheumatica in northwestern Turkey: clinical features and epidemiological data. Clin Exp Rheumatol 27(5):830–833

    CAS  PubMed  Google Scholar 

  3. Bas-Lando M, Breuer GS, Berkun Y, Mates M, Sonnenblick M, Nesher G (2007) The incidence of giant cell arteritis in Jerusalem over a 25-year period: annual and seasonal fluctuations. Clin Exp Rheumatol 25(1 Suppl 44):S15–S17

    CAS  PubMed  Google Scholar 

  4. Gonzalez-Gay MA, Miranda-Filloy JA, Lopez-Diaz MJ, Perez-Alvarez R, Gonzalez-Juanatey C, Sanchez-Andrade A, Martin J, Llorca J (2007) Giant cell arteritis in northwestern Spain: a 25-year epidemiologic study. Medicine 86(2):61–68. https://doi.org/10.1097/md.0b013e31803d1764

    Article  PubMed  Google Scholar 

  5. Petursdottir V, Johansson H, Nordborg E, Nordborg C (1999) The epidemiology of biopsy-positive giant cell arteritis: special reference to cyclic fluctuations. Rheumatology 38(12):1208–1212

    Article  CAS  PubMed  Google Scholar 

  6. Salvarani C, Crowson CS, O'Fallon WM, Hunder GG, Gabriel SE (2004) Reappraisal of the epidemiology of giant cell arteritis in Olmsted County, Minnesota, over a fifty-year period. Arthritis Rheum 51(2):264–268. https://doi.org/10.1002/art.20227

    Article  PubMed  Google Scholar 

  7. Catanoso M, Macchioni P, Boiardi L, Muratore F, Restuccia G, Cavazza A, Pipitone N, Mancuso P, Luberto F, Salvarani C (2017) Incidence, prevalence, and survival of biopsy-proven giant cell arteritis in northern Italy during a 26-year period. Arthritis care & research 69(3):430–438. https://doi.org/10.1002/acr.22942

    Article  Google Scholar 

  8. Boesen P, Sorensen SF (1987) Giant cell arteritis, temporal arteritis, and polymyalgia rheumatica in a Danish county. a prospective investigation, 1982-1985. Arthritis Rheum 30(3):294–299

    Article  CAS  PubMed  Google Scholar 

  9. Dunstan E, Lester SL, Rischmueller M, Dodd T, Black R, Ahern M, Cleland LG, Roberts-Thomson P, Hill CL (2014) Epidemiology of biopsy-proven giant cell arteritis in South Australia. Intern Med J 44(1):32–39. https://doi.org/10.1111/imj.12293

    Article  CAS  PubMed  Google Scholar 

  10. Mohammad AJ, Nilsson JA, Jacobsson LT, Merkel PA, Turesson C (2015) Incidence and mortality rates of biopsy-proven giant cell arteritis in southern Sweden. Ann Rheum Dis 74(6):993–997. https://doi.org/10.1136/annrheumdis-2013-204652

    Article  CAS  PubMed  Google Scholar 

  11. Mader TH, Werner RP, Chamberlain DG, Doornbos D (2009) Giant cell arteritis in Alaska natives. Can J Ophthalmol 44(1):53–56. https://doi.org/10.3129/i08-164

    Article  PubMed  Google Scholar 

  12. Ramstead CL, Patel AD (2007) Giant cell arteritis in a neuro-ophthalmology clinic in Saskatoon, 1998-2003. Can J Ophthalmol 42(2):295–298. https://doi.org/10.3129/canjophthalmol.i07-005

    Article  PubMed  Google Scholar 

  13. Baldursson O, Steinsson K, Bjornsson J, Lie JT (1994) Giant cell arteritis in Iceland. an epidemiologic and histopathologic analysis. Arthritis Rheum 37(7):1007–1012

    Article  CAS  PubMed  Google Scholar 

  14. de Boysson H, Aide N, Liozon E, Lambert M, Parienti JJ, Monteil J, Huglo D, Bienvenu B, Manrique A, Aouba A (2017) Repetitive (18)F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease. Eur J Intern Med 46:66–70. https://doi.org/10.1016/j.ejim.2017.08.013

    Article  CAS  PubMed  Google Scholar 

  15. Ness T, Bley TA, Schmidt WA, Lamprecht P (2013) The diagnosis and treatment of giant cell arteritis. Dtsch Arztebl Int 110(21):376–385; quiz 386. https://doi.org/10.3238/arztebl.2013.0376

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gonzalez-Gay MA, Garcia-Porrua C, Rivas MJ, Rodriguez-Ledo P, Llorca J (2001) Epidemiology of biopsy proven giant cell arteritis in northwestern Spain: trend over an 18 year period. Ann Rheum Dis 60(4):367–371

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Kobayashi S, Yano T, Matsumoto Y, Numano F, Nakajima N, Yasuda K, Yutani C, Nakayama T, Tamakoshi A, Kawamura T, Ohno Y, Inaba Y, Hashimoto H (2003) Clinical and epidemiologic analysis of giant cell (temporal) arteritis from a nationwide survey in 1998 in Japan: the first government-supported nationwide survey. Arthritis Rheum 49(4):594–598. https://doi.org/10.1002/art.11195

    Article  PubMed  Google Scholar 

  18. Schmidt WA, Seifert A, Gromnica-Ihle E, Krause A, Natusch A (2008) Ultrasound of proximal upper extremity arteries to increase the diagnostic yield in large-vessel giant cell arteritis. Rheumatology 47(1):96–101. https://doi.org/10.1093/rheumatology/kem322

    Article  CAS  PubMed  Google Scholar 

  19. Muratore F, Kermani TA, Crowson CS, Green AB, Salvarani C, Matteson EL, Warrington KJ (2015) Large-vessel giant cell arteritis: a cohort study. Rheumatology 54(3):463–470. https://doi.org/10.1093/rheumatology/keu329

    Article  PubMed  Google Scholar 

  20. Luqmani R, Lee E, Singh S, Gillett M, Schmidt WA, Bradburn M, Dasgupta B, Diamantopoulos AP, Forrester-Barker W, Hamilton W, Masters S, McDonald B, McNally E, Pease C, Piper J, Salmon J, Wailoo A, Wolfe K, Hutchings A (2016) The role of ultrasound compared to biopsy of temporal arteries in the diagnosis and treatment of giant cell arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study. Health Technol Assess 20(90):1–238. https://doi.org/10.3310/hta20900

    Article  PubMed  PubMed Central  Google Scholar 

  21. Diamantopoulos AP, Haugeberg G, Hetland H, Soldal DM, Bie R, Myklebust G (2014) Diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: a consecutive case series. Arthritis care & research 66(1):113–119. https://doi.org/10.1002/acr.22178

    Article  Google Scholar 

  22. Hauenstein C, Reinhard M, Geiger J, Markl M, Hetzel A, Treszl A, Vaith P, Bley TA (2012) Effects of early corticosteroid treatment on magnetic resonance imaging and ultrasonography findings in giant cell arteritis. Rheumatology 51(11):1999–2003. https://doi.org/10.1093/rheumatology/kes153

    Article  CAS  PubMed  Google Scholar 

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Affiliations

  1. Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova cesta 62, 1000, Ljubljana, Slovenia

    Nataša Potočnik Pucelj, Alojzija Hočevar, Rok Ješe, Žiga Rotar & Matija Tomšič

  2. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Nataša Potočnik Pucelj, Alojzija Hočevar, Rok Ješe, Marko Hawlina & Matija Tomšič

  3. Department of Opthalmology, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Marko Hawlina & Ana Fakin

  4. Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

    Jože Pižem

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  1. Nataša Potočnik Pucelj
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  2. Alojzija Hočevar
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Correspondence to Alojzija Hočevar.

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Rheumatology in Slovenia: Clinical practice and translational research

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Pucelj, N.P., Hočevar, A., Ješe, R. et al. The incidence of giant cell arteritis in Slovenia. Clin Rheumatol 38, 285–290 (2019). https://doi.org/10.1007/s10067-018-4236-6

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  • DOI: https://doi.org/10.1007/s10067-018-4236-6

Keywords

  • Epidemiology
  • Giant cell arteritis
  • Incidence