Seasonal variation in biopsy‐proven giant cell arteritis in Eastern Denmark from 1990‐2018

Abstract

Purpose The purpose of this study was to investigate seasonal variation in cases of biopsy‐proven GCA in eastern Denmark in a 29‐year period. Methods Pathology records of all temporal artery biopsies in eastern Denmark between 1990 and 2018 were reviewed. For each patient, data were collected which included age, sex, date of birth and biopsy result. Seasonality was evaluated using logistic regression and Poisson regression analysis. Lastly, an explorative pilot study was conducted to investigate a possible association between three weather parameters (average temperature, amount of rain and hours of sunshine) and the biopsy outcome. Results One thousand three hundred twenty‐three biopsies were included of which 336 fulfilled objective criteria for GCA diagnosis. Mean age at diagnosis was 75.6 years (range 52–94 years). Among the biopsy‐proven cases of GCA, there were 223 women (66.3%, mean age 76.2 years) and 113 men (33.7%, mean age 74.4 years) giving a female to male ratio of 1.97:1. The peak occurrence of GCA was in the 70–79 years age group. Statistical analysis of seasonal variation showed an increased risk of a positive biopsy during summer compared to autumn (p = 0.037). No association between the three weather parameters and the biopsy outcome was found. Conclusion In this study of biopsy‐proven GCA in a large Danish patient cohort, the occurrence of GCA showed seasonal variation with higher occurrence in the summer months when compared to autumn. Future studies pooling all cases of GCA worldwide are needed to determine seasonality in the occurrence of GCA.

Current Perspectives in Giant Cell Arteritis: Can We Better Connect Pathogenesis and Treatment?

“…The higher infection rate in GCA patients compared with age-matched controls, especially in the upper respiratory tract [ 25 ], and the seasonal variations reported by some studies [ 26 ] could suggest an environment–infection relationship. Three relatively recent studies, one North American [ 26 ] and two Northern European [ 27 , 28 ], that evaluated the timing of diagnosis of biopsy-confirmed GCA reached similar conclusions, namely, a higher rate of occurrence during the summer months, while data from Australasia [ 29 ] did not confirm this aspect. It was speculated that some viral (varicella–zoster and parainfluenza virus type 1) or bacterial (Chlamydia pneumoniae and Mycoplasma pneumoniae) microorganisms might be related to GCA etiology, but no proof was found in specimen biopsy [ 30 , 31 , 32 , 33 ].…”

Incidence of biopsy-proven giant cell arteritis (GCA) in South Australia 2014–2020

“…This has led to studies of seasonal variation in GCA incidence. A seasonal increase in GCA incidence has been reported in some studies with peaks in the summer months in the USA (6) and Europe (7); however, a previous study did not confirm this in Australia (8). This is supported by a recent comprehensive meta-analysis (9) which did not confirm a seasonal onset for GCA.…”

Current Insights into Tissue Injury of Giant Cell Arteritis: From Acute Inflammatory Responses towards Inappropriate Tissue Remodeling

“…Females exhibit an almost threefold increased likelihood of developing GCA compared to males, with a propensity for more extracranial artery involvement and a higher prevalence of PMR [ 6 ]. Seasonal variation adds another layer to the epidemiological profile, with a notable preponderance of diagnoses during the spring and summer [ 7 , 8 ].…”