Erythrocyte sedimentation rate and its relationship to hematocrit in giant cell arteritis
D. M. Jacobson and T. L. Slamovits
We separated 24 patients with biopsy-proved giant cell arteritis into three
groups based on erythrocyte sedimentation rates (ESRs) at clinical
presentation: low, 1 to 40 mm/h; high, 41 to 80 mm/h; and very high,
greater than 80 mm/h. The presence of anemia in the very high ESR group
compared with the low ESR group was the only statistically identified
difference. A linear regression analysis confirmed a high degree of inverse
correlation between ESR and hematocrit in the subject population. There was
no difference in ischemic ocular complications among the three groups.
These findings emphasize that the diagnosis of giant cell arteritis should
be made predominantly on clinical suspicion with less reliance on the ESR
as a diagnostic criterion. Furthermore, the degree of ESR elevation does
not predict which patients are at increased risk for the development of
ocular complications. Finally, the ESR may not reliably indicate active
disease in patients with normal hematocrit values.
