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Should I have temporal biopsy for GCA even after 8 weeks prednisone?
Polymyalgia Rheumatica (PMR) | Last Active: Mar 21 5:38pm | Replies (21)Comment receiving replies
I was diagnosed with GCA and PMR about 8 months ago. My GCA was confirmed with a biopsy the second day of treatment with high dose prednisone. My sed rate was 54 and my CRP was 9. I just googled "how long is a temporal artery biopsy valid after starting prednisone for GCA", and the results varied from 1 to 4 weeks, but I did find one small study where a positive biopsy occurred after 45 days of prednisone treatment. My understanding is that besides the recovery of giants cells from prednisone treatment, the biopsy can have a false negative by being performed in a section of the artery where there aren't any giant cells (skip lesions). I would advise you to not have the biopsy, but your headaches are concerning. I never had headaches with my GCA, but I had almost all of the other standard symptoms, including episodes of temporary vision loss in one eye. I got treatment in time to save my vision.
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Thank you for your reply. I have read the same kinds of things about skip lesions and prednisone treatment potentially producing a false negative reading. I was diagnosed after complaining of pain and stiffness for a little over 2 weeks which my PCP ignored as possible statin side effect ( new medication for me)and told me to try to continue statin. I finally threw in the towel because of excruciating pain and told him I would not continue statin and asked if I had PMR...a friend suggested that's what I had. PCP ran blood work and although my inflammation markers were low, he diagnosed PMR. So, I started prednisone at 20 MG for 1 week. Then he lowered it to 15MG for 20 days....then he wanted me to go to 10 MG, but I balked because of all I had read about slower taper and I went to 12.5 MG for another 19 days. Then I saw rheumatologist...she wants the GCA test because of headaches, but at this point I don't think ultrasound or biopsy are going to be reliable...so what do I do? Get another opinion? My inclination is to try ultrasound because it cannot hurt. I wish I could remember when the headaches started...if it was only after the prednisone, is it possible that these are prednisone headaches?