Ophthalmic Presentation of GCA in African Americans
Published online Sept. 16, 2016
Garrity et al. compared the presenting characteristics of giant cell arteritis (GCA) between African Americans and Caucasians. The researchers found that the features were not markedly distinct, but they did identify a few significant differences.
In this multicenter retrospective case series, neuro-ophthalmologists at 10 institutions provided data on biopsy-proven GCA in a total of 32 patients who self-identified as African American. These cases were compared against a previously published cohort of 84 Caucasian patients with GCA. Characteristics that were compared included age, sex, erythrocyte sedimentation rate, C-reactive protein level, ophthalmic symptoms, and ischemic lesions.
The researchers found that the mean age of the African American cohort was slightly lower than that of the Caucasian cohort (72.6 years vs. 76.1 years); notably, 1 of the African Americans was 46 years old, which is younger than any previously reported cases. There was no difference in sex distribution between the groups, with women comprising more than two-thirds of the patients in both groups.
The most common presentation of giant cell arteritis in both groups was acute vision loss, though it was less common in African Americans (78% vs. 98% of Caucasians, p < .001). Eye pain was more common in African Americans (28% vs. 8% of Caucasians, p < .01). With regard to systemic signs and symptoms, headache, neck pain, and anemia were more frequent in African Americans, while jaw claudication was noted to be less frequent (p values < .01, < .001, < .02, and < .03, respectively).
The researchers concluded the similarities in presentation of GCA between African Americans and Caucasians outnumber the differences. They recommended that GCA should be part of the differential diagnosis for any patient, regardless of race, who has suggestive signs or symptoms.
The original article can be found here.