Temporal arteritis with low erythrocyte sedimentation rate: A review of five cases

Abstract

We compared 5 patients who had biopsy‐proven temporal arteritis and erythrocyte sedimentation rates (ESR) <50 mm/hour with 25 patients who had temporal arteritis and high ESR and with 10 patients who had negative temporal artery biopsy results and low ESR. Patients with low‐ESR temporal arteritis were similar to the other groups, except that they had a higher mean hemoglobin level than the high‐ESR group and a significant increase in the percentage of patients (4 of 5) who had a previous diagnosis of polymyalgia rheumatica or had received steroid therapy compared with either of the other groups. The latter finding suggests that even low‐dose steroid therapy can lower the ESR in patients with temporal arteritis. We conclude that the ESR is low in only a small percentage of patients with temporal arteritis, and that most of these patients have a history of polymyalgia rheumatica or steroid therapy. Copyright © 1991 American College of Rheumatology