Vasculitis & polymyalgia rheumatica
Giant cell arteritis associated with scalp, tongue or lip necrosis: A French multicenter case control study
Authors' conclusion
Our results suggest that scalp, tongue, and/or lip necrosis is associated to higher mortality in GCA patients. Scalp tenderness and cognitive disorder were significant factors associated to this very rare complication of GCA.
Study context
- Population
- Giant cell arteritis (GCA) patients with scalp, tongue and/or lip necrosis and matched GCA controls, French multicenter study, 1998–2021
- Participants
- 20 vs 80
- Comparison
- GCA with scalp, tongue and/or lip necrosis vs matched GCA controls
- Necrosisn = 20
- Controlsn = 80reference
- Outcome
- Baseline characteristics associated with scalp, tongue and/or lip necrosis
Methodological detailsnationwide, multicenter, matched for age, sex and management period, multivariable logistic regression
- Nationwide
- Multicenter
- Matched for age, sex and management period
- Multivariable logistic regression
Main finding
As reported in the abstract
Factors associated with scalp, tongue and/or lip necrosis (multivariable logistic regression)
Odds ratio (95 % CI)P value
Scalp tenderness
4.81(1.57–14.79)
P = 0.006Cognitive disorder
6.42(1.01–40.60)
P = 0.048Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Cranial manifestationsNecrosis vs Controls · significantly more in Necrosis | headache, p=0.045 |
| Cranial manifestationsNecrosis vs Controls · significantly more in Necrosis | scalp tenderness, p=0.006 |
| Cranial manifestationsNecrosis vs Controls · significantly more in Necrosis | jaw claudication, p=0.02 |
| SurvivalSurvival decreased in Necrosis | P = 0.003 |
Visual symptoms and large vessel involvement
- No differences between both groups
Treatment at diagnosis
- Necrosis patients more likely received IV methylprednisolone infusions and higher doses of oral prednisone
Vascular complications during follow up
- No differences
Original publication
Giant cell arteritis associated with scalp, tongue or lip necrosis: A French multicenter case control study. Semin Arthritis Rheum. Published 10 December 2023. doi:10.
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