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Rheumatology 2000; 39: 1089-1094
© 2000 British Society for Rheumatology

Anticardiolipin antibody levels predict flares and relapses in patients with giant-cell (temporal) arteritis. A longitudinal study of 58 biopsy-proven cases

E. Liozon, P. Roblot1, D. Paire2, V. Loustaud, F. Liozon, E. Vidal and M. O. Jauberteau2

Departments of Internal Medicine, University Hospitals of Limoges and
1 Poitiers and
2 Immunology Laboratories, Limoges, France

Objective. To evaluate the usefulness of anticardiolipin antibodies (aCL) in identifying flares and relapses in giant-cell arteritis.

Methods. We studied 58 consecutive patients with biopsy-proven temporal giant-cell arteritis. C-reactive protein and aCL serum levels were measured simultaneously at the time of diagnosis and at each out-patient visit until recovery. All observed episodes of a rise in C-reactive protein attributable to a precise cause, for which the simultaneous measurement of aCL was available, were analysed.

Results. The mean duration of clinical observation and serum aCL assessment was 34 ± 18 and 24 ± 11 months, respectively. Anticardiolipin antibody positivity (IgG or total antibodies >=20 U) before treatment was found before treatment in 27 cases (46.6%) (mean 45.6 ± 26 U/l, range 20–110 U). Levels of aCL decreased below 10 U with appropriate treatment in all patients except one, after a variable delay. No rise in aCL levels was recorded subsequently in any patient whose disease was controlled permanently. A significant rise in aCL was recorded in 20 of 27 (74%) of the flares or relapses of giant-cell arteritis, including seven of 12 flares in seven patients whose initial aCL level was <20 U vs none of the 28 inflammatory episodes unrelated to giant-cell arteritis (P < 0.0000001). IgM aCL, infrequently found at diagnosis, was not associated with signs of disease activity.

Conclusion. Serum aCL levels are useful in the detection of flares and relapses in giant-cell arteritis, with fairly good sensitivity (74%) and a specificity of 100%, and can be of value in distinguishing subclinical flares from infection.

KEY WORDS: Giant cell arteritis, Anticardiolipin antibodies, Flare.

Correspondence to: E. Liozon, Service de Médecine Interne A, Hôpital Universitaire Dupuytren, 2 av. Martin Luther-King, Limoges, France.


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