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Evaluation of revised classification criteria for giant cell arteritis and its clinical phenotypes

Wiberg, Frans ; Naderi, Nazanin LU orcid ; Mohammad, Aladdin J. LU and Turesson, Carl LU (2022) In Rheumatology (United Kingdom) 61(1). p.383-387
Abstract

Background: GCA is a systemic vasculitis of the elderly, viewed by many as a disease with multiple and overlapping clinical phenotypes. Retrospective studies have shown differences in clinical presentation between these phenotypes. To reflect the heterogeneity of GCA and novel diagnostic methods, new classification criteria have been proposed. Methods: This is a retrospective study of newly diagnosed patients with GCA at the outpatient rheumatology clinics at Skåne University Hospital (Malmö and Lund) between 2012 and 2018. All patients were evaluated using two sets of classification criteria, the ACR classification criteria from 1990 and a proposed revision of these criteria requiring objective findings (positive biopsy or imaging) for... (More)

Background: GCA is a systemic vasculitis of the elderly, viewed by many as a disease with multiple and overlapping clinical phenotypes. Retrospective studies have shown differences in clinical presentation between these phenotypes. To reflect the heterogeneity of GCA and novel diagnostic methods, new classification criteria have been proposed. Methods: This is a retrospective study of newly diagnosed patients with GCA at the outpatient rheumatology clinics at Skåne University Hospital (Malmö and Lund) between 2012 and 2018. All patients were evaluated using two sets of classification criteria, the ACR classification criteria from 1990 and a proposed revision of these criteria requiring objective findings (positive biopsy or imaging) for classification. Patients were further classified as one of four widely used clinical phenotypes. Results: A total of 183 patients with a new diagnosis of GCA were identified. The diagnosis was confirmed by one or two experienced rheumatologists in 116 of these patients during a review of medical records. The ACR criteria were more sensitive than the revised criteria (93.1% vs 72.4%), but the revised criteria had higher specificity (94.0% vs 28.4%). The revised criteria tended to have higher sensitivity in the phenotype with constitutional symptoms compared with cranial GCA (P = 0.08). Conclusion: The specificity of the ACR classification criteria for GCA can be improved by using revised criteria requiring objective findings of vasculitis. In addition, the wider symptoms covered by the revised criteria may improve classification of patients with a phenotype characterized by constitutional symptoms.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
classification criteria, giant cell arteritis, phenotypes
in
Rheumatology (United Kingdom)
volume
61
issue
1
pages
5 pages
publisher
Oxford University Press
external identifiers
  • pmid:33871583
  • scopus:85125016831
ISSN
1462-0324
DOI
10.1093/rheumatology/keab353
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.
id
9a5cd4d8-2670-4b25-99d3-4b8445a7778b
date added to LUP
2022-04-13 16:03:48
date last changed
2025-02-12 15:58:17
@article{9a5cd4d8-2670-4b25-99d3-4b8445a7778b,
  abstract     = {{<p>Background: GCA is a systemic vasculitis of the elderly, viewed by many as a disease with multiple and overlapping clinical phenotypes. Retrospective studies have shown differences in clinical presentation between these phenotypes. To reflect the heterogeneity of GCA and novel diagnostic methods, new classification criteria have been proposed. Methods: This is a retrospective study of newly diagnosed patients with GCA at the outpatient rheumatology clinics at Skåne University Hospital (Malmö and Lund) between 2012 and 2018. All patients were evaluated using two sets of classification criteria, the ACR classification criteria from 1990 and a proposed revision of these criteria requiring objective findings (positive biopsy or imaging) for classification. Patients were further classified as one of four widely used clinical phenotypes. Results: A total of 183 patients with a new diagnosis of GCA were identified. The diagnosis was confirmed by one or two experienced rheumatologists in 116 of these patients during a review of medical records. The ACR criteria were more sensitive than the revised criteria (93.1% vs 72.4%), but the revised criteria had higher specificity (94.0% vs 28.4%). The revised criteria tended to have higher sensitivity in the phenotype with constitutional symptoms compared with cranial GCA (P = 0.08). Conclusion: The specificity of the ACR classification criteria for GCA can be improved by using revised criteria requiring objective findings of vasculitis. In addition, the wider symptoms covered by the revised criteria may improve classification of patients with a phenotype characterized by constitutional symptoms.</p>}},
  author       = {{Wiberg, Frans and Naderi, Nazanin and Mohammad, Aladdin J. and Turesson, Carl}},
  issn         = {{1462-0324}},
  keywords     = {{classification criteria; giant cell arteritis; phenotypes}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{1}},
  pages        = {{383--387}},
  publisher    = {{Oxford University Press}},
  series       = {{Rheumatology (United Kingdom)}},
  title        = {{Evaluation of revised classification criteria for giant cell arteritis and its clinical phenotypes}},
  url          = {{http://dx.doi.org/10.1093/rheumatology/keab353}},
  doi          = {{10.1093/rheumatology/keab353}},
  volume       = {{61}},
  year         = {{2022}},
}