Temporal arteritis in Hong Kong

Abstract

Objective: To evaluate Chinese patients with biopsy-proven temporal arteritis in Hong Kong, focusing on clinical presentation, frequency of occurrence, treatment regimen and complications, management and outcome of these patients. Design: A retrospective study. Method: A retrospective study was undertaken in which patients with biopsy-proven temporal arteritis were identified from: (i) Statistical records of Hospital Authority (1996-1999); (ii) pathology records of regional hospitals in Hong Kong (1996-2000); and (iii) case records from rheumatologists in two university hospitals. Indexed hospital and out-patient records were reviewed and analysed. Results: Nineteen patients with biopsy-proven temporal arteritis were identified from 1996 to 2000 and the calculated annual incidence was 0.34 patients in 100,000 people aged 50 and above per year. There were six male and 13 female patients (male : female ratio 1:2.2). Sixteen (84%) patients were older than 70 years. The common presentations were similar to overseas studies and included headache (79%), muscular symptoms (42%), constitutional symptoms (37%), scalp tenderness (37%), visual loss (32%), jaw claudication (32%), abnormal temporal artery (32%), and fever (26%). The mean erythrocyte sedimentation rate before treatment was 104 mm/h (SD = 30 mm/h). Anemia (Hb < 12 g/dL) was present in 79% of patients. The mean duration of symptoms before diagnosis was 8.4 weeks. Seventeen (89%) patients received high-dose steroid therapy but none received steroid-sparing agents. Only 33% of patients reached a physiological dose of steroid (prednisolone 5 mg/day) after 1 year. Conclusion: Temporal arteritis is rare among Hong Kong Chinese. A rough estimate of annual incidence yielded less than one per 100,000 people aged ≥.50. Overall clinical presentation was similar to overseas studies but there were: (i) longer duration of steroid therapy given; and (ii) more complications from steroid use. Steroid-sparing agents should be considered early in difficult-to-control cases. © 2008 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.