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Geographical and Genetic Factors Do Not Account for Significant Differences in the Clinical Spectrum of Giant Cell Arteritis in Southern Europe
MIGUEL A. GONZALEZ-GAY, LUIGI BOIARDI, CARLOS GARCIA-PORRUA, PIERLUIGI MACCHIONI, JUAN C. AMOR-DORADO, and CARLO SALVARANI
ABSTRACT. Objective. To investigate whether genetic and geographical differences may influence the clinical spectrum of giant cell arteritis (GCA), we compared the demographic and clinical features of patients with biopsy-proven GCA from Reggio Emilia (Northern Italy) and Lugo (Northwest Spain) during a 15-year period. Methods. We performed a retrospective review of the case records of all patients diagnosed with biopsy-proven GCA at Hospital Xeral-Calde (Lugo, Spain) and Hospital Santa Maria Nuova (Reggio Emilia, Italy) between 1 January 1986 and 31 December 2001. Both hospitals are the only referral centers for populations living in central Galicia and central Emilia Romagna, respectively. Results. During the period of study, 194 Lugo residents and 126 Reggio Emilia residents were diagnosed with biopsy proven GCA. Reggio Emilia patients were more likely to be female (74% vs 54%; p = 0.0001). Although Lugo patients complained of headache (86%) more commonly than did those from Reggio Emilia (77%), the difference was only marginally significant (p = 0.05). The proportion of patients with visual manifestations or visual loss was remarkably similar (22% for visual manifestations and 17% for visual loss in Lugo and 29% and 21% for Reggio Emilia residents). The mean erythrocyte sedimentation rate prior to the onset of therapy was also similar. Conclusion. Apart from differences in sex, the clinical spectrum of GCA in these 2 Southern European regions was similar. (J Rheumatol 2004;31:520-3) Key Indexing Terms:
GIANT CELL ARTERITIS From the Divisions of Rheumatology and Otolaryngology, Hospital Xeral-Calde, Lugo, Spain and the Division of Rheumatology, Arcispedale S. Maria Nuova, Reggio Emilia, Italy. M.A. Gonzalez-Gay, MD, PhD; C. Garcia-Porrua. MD, PhD, Rheumatology Division; J.C. Amor-Dorado, MD, Otolaryngology Division, Hospital Xeral-Calde; L. Boiardi, MD, PhD; P.L. Macchioni, MD; C. Salvarani, MD, Division of Rheumatology, Arcispedale S. Maria Nuova. Address reprint requests to Dr. C. Salvarani, Division of Rheumatology, Arcispedale S. Maria Nuova, c/ Viale Risorgimento, No. 80, 42100 Reggio Emilia, Italy. E-mail: salvarani.carlo@asmn.re.it Submitted May 20, 2003; revision accepted August 18, 2003. |