| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Rheumatology 2001; 40: 1193
© 2001 British Society for Rheumatology
Letters to the Editor |
Giant cell arteritis is more prevalent in urban than in rural populations
Eye Hospital and
1 Department of Medical Biometrics and Statistics, University Hospital Freiburg, D-79106 Freiburg, Germany
SIR, Reinhold-Keller et al. [1] recently described a study of the epidemiology of primary systemic vasculitides. They found that in both northern and southern Germany, the prevalence of giant cell arteritis (GCA) was significantly higher in urban than in rural populations. The relative risk for the older urban population having GCA was 2.25-fold higher than in the rural population. The findings by these authors are confirmed by our data, published in 1995 [2]. In a retrospective study of 99 patients with GCA over a 10-yr follow-up (1982–1991), we found an incidence of 2.07 of GCA in southern Germany. In the rural population, the incidence was approximately half the urban incidence.
Accepted 12 April 2001
References
-
Reinhold-Keller E, Zeidler A, Gutfleisch J, Peter HH, Raspe HH, Gross WL. Giant cell arteritis is more prevalent in urban than in rural populations: result of an epidemiological study of primary systemic vasculitides in Germany. Rheumatology2000;39:1396–402.
[Abstract/Free Full Text] - Schmidt D, Schulte-Mönting J. Häufigkeit der Arteriitis temporalis (Frequency of temportal arteritis). In: Schmidt D, ed. Arteriitis temporalis Horton. St Gallen: Elephas-Verlag, 1995:79.
Reply
Rheumaklinik, Oskar-Alerander-Str. 26, D-24576 Bad Bramstedt, Germany
Thank you for the attention to our data on the epidemiology of primary systemic vasculitides in northern and southern Germany in two cities and rural regions. Unlike our study, Schmidt and Schulte-Mönting did not conduct a population-based study on the epidemiology of giant cell arteritis (GCA). Their hospital-based data from a large university hospital for eye diseases in the city of Freiburg, Germany, are likely to be influenced by referral bias. However, their observations were confirmed by our data which revealed a more than 2-fold higher GCA prevalence in an urban population vs a rural population. Both results could support our hypothesis that these differences do not represent ‘true’ differences between rural and urban regions. They could be caused by obvious differences in the German medical care structure. The ratio of physicians to inhabitants, e.g. specialized physicians (internal medicine, rheumatologists, ophthalmologists, etc.) was 2-fold higher in the cities than in rural regions, possibly leading to less frequent confirmation of the diagnosis of (sometimes mild) GCA in rural regions.
Accepted 12 April 2001
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||