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首页> 外文期刊>Internal medicine journal >Full blood count as an ancillary test to support the diagnosis of giant cell arteritis
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Full blood count as an ancillary test to support the diagnosis of giant cell arteritis

机译：全血计数作为辅助测试，以支持巨型细胞动脉炎的诊断

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Abstract Background Temporal artery biopsy is considered the investigation of choice to diagnose definitively giant cell arteritis (GCA) in patients with compatible symptoms. However it is invasive and not completely sensitive. Serum markers, particularly erythrocyte sedimentation rate (ESR), can be supportive, but are not definitive in individual cases. Aims To investigate whether indices derived from the full blood count, including neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) were associated with a positive biopsy in patients with suspected GCA. Methods The clinical and pathological details of 537 patients undergoing temporal artery biopsy at our institution from 1992 to 2015 were reviewed. Results In univariate analysis high platelets (odds ratio (OR) 4.44, P 0.001), NLR (OR 1.81, P = 0.02), PLR (OR 3.25, P 0.001), C‐reactive protein (CRP) (OR 3.00, P 0.001), ESR (OR 3.62, P 0.001) and increased age (OR 1.03, P = 0.006) were strongly associated with a positive biopsy. In multivariate modelling only high platelets ( P 0.001) and ESR ( P = 0.049) maintained significance. Conclusions We conclude that the presence of thrombocytosis and high NLR, PLR, ESR and CRP can all be used clinically to support the diagnosis of GCA prior to biopsy. Of particular note, in multivariate modelling the presence of thrombocytosis is a stronger predictor of a positive temporal artery biopsy than ESR. Therefore, careful consideration of the findings in a full blood count can be used to predict the likelihood of a positive temporal artery biopsy in patients with suspected GCA.
机译：摘要背景颞动脉活检被认为是涉及伴随症状患者诊断明确的巨型细胞动脉炎（GCA）的选择。然而，它是侵入性的，并且没有完全敏感。血清标记，特别是红细胞沉降率（ESR），可以支持，但在单个情况下并不明确。旨在调查源自血液计数的索引是否源自血液计数（包括中性粒细胞 - 淋巴细胞比（NLR）和血小板到淋巴细胞比（PLR）与疑似GCA患者的阳性活组织检查有关。方法综述了1992年至2015年在2019年至2015年在我们所在机构接受颞动脉活检的537例患者的临床和病理细节。导致单变量分析高血小板（OTS比率（或）4.44，P <0.001），NLR（或1.81，P <0.02），PLR（或3.25，P <0.001），C-反应蛋白（CRP）（或3.00，P <0.001），ESR（或3.62，P <0.001）和增加的年龄（或1.03，P = 0.006）与阳性活组织检查密切相关。在多变量建模中仅高血小板（P <0.001）和ESR（P = 0.049）保持显着性。结论我们得出结论，临床上的血小盲症和高NLR，PLR，ESR和CRP的存在可以在活组织检查之前支持GCA的诊断。特别注意，在多变量建模中，血小板抑制的存在是阳性时间动脉活组织检查的较强预测因子，而不是ESR。因此，仔细考虑全血计数中的发现可用于预测疑似GCA患者患者阳性时间动脉活组织检查的可能性。

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  • 来源
    《Internal medicine journal》 |2018年第4期|共6页
  • 作者

    Oh Lawrence J.; Wong Eugene; Andrici Juliana; McCluskey Peter; Smith James E. H.; Gill Anthony J.;

  • 作者单位

    Faculty of MedicineSydney Medical School University of SydneySydney New South Wales Australia;

    Faculty of MedicineSydney Medical School University of SydneySydney New South Wales Australia;

    Faculty of MedicineSydney Medical School University of SydneySydney New South Wales Australia;

    Faculty of MedicineSydney Medical School University of SydneySydney New South Wales Australia;

    Faculty of MedicineSydney Medical School University of SydneySydney New South Wales Australia;

    Faculty of MedicineSydney Medical School University of SydneySydney New South Wales Australia;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 内科学;
  • 关键词

    giant; cell; temporal; arteritis; blood; count;

    机译：巨型;细胞;时间;动脉炎;血液;数量;

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