PO248 Audit on efficacy of temporal artery biopsy (tab) for giant cell arteritis (gca) in lancashire teaching hospital nhs foundation trust

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Abstract

GCA is the commonest type of systemic vasculitis in patients above the age of 50 years. TAB is the cornerstone of diagnosis. In the right clinical setting, harvesting adequate TAB sample is crucial in making the correct diagnosis and for guiding treatment. Guidelines set by RCP on diagnosis and management of GCA (2010) as standard for this audit. A total of 148 TAB was carried out during that 5 year period. It was positive for arteritis in 37 (25%) cases and equivocal results in 3 (2%) cases. Inadequate sample was obtained in 3 (2%) cases. A repeat biopsy was carried out only in 4 (2.7%) cases, 2 for patients with inadequate samples. The mean sample size was 11.8 (range 6.1–17.5) mm. Minimum sample size was 3 mm (3 cases, 2%) and maximum sample size was 40 mm (1 case, 0.7%). In 43.2% cases the biopsy sample was greater than 10 mm (set minimum by RCP guidelines). This audit results suggest that in 56.1% cases the size of the TAB obtained were less than 10 mm (inadequate with risk of missing skip lesions). A trust policy to obtain at least 20 mm sample was made to improve diagnostic yield.

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