Temporal biobsy

[Poppylop]

Hi all, my rheumatologist appointment is next Wednesday as I have mentioned previously but ive also had another appointment come through for the following day, I'm assuming it's a mix up, I'm going to ring them shortly to double check, but was just wondering as I've already been on 40mg pred for what will be 4 weeks by the time I see the rheumatologist do you think they are still going to do a biopsy because surely they won't get a correct reading as the inflammation has gone down massivly, I don't want it done if it's a pointless result after all this time x

[SnazzyD]

And that’s the problem. Opinions vary about how long is too long to be on Pred too. I had mine done after 8 days on Pred with massive improvement in symptoms, it was negative but they still went down the same path of management because of my symptoms and the great response to Pred. It made no difference but if it had been positive I would have known it was all worth it. Others have had a positive result after longer. However, if it were me, I’d be very reluctant after 4 weeks as the test is already complicated with other reasons that give a false negative. I would question them to see if it would make any difference if it were negative, though some docs have used it as their main diagnostic evidence.

[SheffieldJane]

You are right, your treatment with Prednisalone will impact on your results. You really need to talk this through with your consultant. This is not a procedure you want to have pointlessly. What value will it add to the treatment of your condition? Try to have this conversation. Sometimes we do find ourselves on a production line and the diagnostic test or treatment is no longer necessary. Let us know what advice you receive.

[Marijo1951]

I had my biopsy the day after I was diagnosed and the result was definitely positive. I was grateful to have this confirmation. However the procedure wasn't much fun and I certainly wouldn't want it if it was likely to be pointless.

[PMRpro Ambassador]

It's unlikely they will find much after 4 weeks at a high dose like that. The question to ask is whether having it and then finding it is negative will make a difference to your treatment because it being negative doesn't mean it isn't GCA, it means they didn't find what they were looking for and there are a lot of reasons that might happen. If they will still treat it as GCA - what is the point of the biopsy?

[Labradorite]

I hope your appointment goes well next Wednesday.

I had an appointment with a rheumatologist two weeks after a suspected GCA diagnosis. I didn’t have a temporal artery biopsy at this time because the rheumatologist considered it unnecessary after consideration of my symptoms, my response to 60mg daily of prednisolone, plus a family history of GGA/ PMR. She told me I had 'a history classical of GCA'. She explained that biopsy could give a false negative result, and in my case a negative biopsy would not make a difference to my treatment.

So, if you are offered a biopsy, ask if a negative result would make a difference to your treatment. Depending on the hospital, it is possible that you will be given an ultrasound scan of the temporal and axillary arteries to look for signs of inflammation.

[Janstr]

I had a negative biopsy after only 10 days on pred, and was treated for GCA anyway based on clinical symptoms. I found the procedure quite invasive & if I was in the same position again would choose not to have it.

[Janstr]

I meant to say that after having the biopsy done, I couldn't bear the thought of having a hair dresser anywhere near me, & wished I had had it seen to before.