Hi to everyone out there. Just wondered if anybody can tell me how they do this biopsy for GCA? Been back to GP today and my levels have gone down from19 to 12 but she now wants a biopsy done so any advice etc would be welcome. All good wishes to everybody on this awful dreary day.
Labrador Lover
I have not had a biopsy, but I am wondering at what stage other people are usually tested for GCA. This is my biggest fear - having GCA, but my Dr does not seem concerned. I had the frontal headache/blurry eyes for a few weeks before diagnosis and starting Predisone. After a week on 20mg, the headache went away, but when I was dropped to 15mg, headache, blurry eyes, and facial sweating returned immediately Should I push for a test or am I worrying unnecessarily ?
Flutterbie, if a GP suspects that a patient may have GCA affecting the temporal arteries, s/he should start the patient on high dose steroids there and then (at least 40mg) and arrange immediate referral to a rheumatologist for confirmation/biopsy. The biopsy needs to be carried out within the first couple of weeks of steroid treatment - any later and the large cells they are looking for will have resolved due to the treatment. Although the biopsy is still the standard diagnostic test for GCA, it may not always result in 100% confirmation of diagnosis in that sometimes any large cells can escape the tiny portion of artery biopsied. There is a superior scanning test (PET scan) but it is only available for GCA testing at a couple of centres in the country.
If you reduced from 20mg straight to 15mg, then that would explain your returning symptoms. 17.5mg would likely have proved more successful. Have you had your "blurry" vision checked by an ophthalmologist? If this symptom was controlled at the 20mg dose, then it could point to it being GCA. However, steroids themselves can cause blurring of the vision. If in doubt/if it worsens, have it checked - at A&E if necessary.
Hi LL: I had a temporal artery biopsy done a few months ago. It is pretty simple because the temporal artery lies just beneath the skin. The doctor gave me a local anesthetic, then cut through the skin, took a sample of the artery, and sewed it up. The sample is sent to a pathologist who looks for “giant cells” and perhaps other signs of inflammation.
I had a scar about an inch long, but hidden in the hair. Absolutely no big deal.
As Mrs. O says, the biopsy has to be done soon after starting prednisone, or the pred will have reduced the signs the pathologist is looking for.
If the biopsy is positive, it confirms the diagnosis of GCA. However, if is negative, it is not proof that you do not have it, only that the cells were not detected in the sample. You could have a problem in a downstream branch of the artery or the sample taken might not have included any giant cells. It is still worth doing because, if you have GCA you really want to know that you do!
Best of luck!