Background/Purpose: Giant cell arteritis (GCA) is a large and medium vessel vasculitis affecting older adults of Northern European descent. While GCA is well characterized in Caucasian (CA) populations, emerging data suggest possible racial differences in disease expression. This study aimed to assess racial variation in clinical and lab presentation of GCA between African American (AA) and CA patients.

Methods: We performed a retrospective chart review of patients meeting the 2022 ACR/EULAR classification criteria for GCA in the Rheumatology Department at University Hospitals. Patients were categorized as AA vs. CA. Extracted data included demographics, presenting symptoms, temporal artery biopsy (TAB) status and results, relapse, mortality, and lab parameters at diagnosis. This study was IRB approved. Chi-square (χ²) tests evaluated associations between race and categorical variables; Two-sided t-tests assessed continuous variables.

Results: Sixty-five patients (55 CA, 10 AA) were included. In this comparative analysis, mean age at diagnosis was similar (78.75 vs. 78.6 years, p = 0.486). All AA patients were female vs. 72.7% CA (p = 0.060). TAB was positive in 69.1% of CA vs. 20% of AA (p=0.003). Clinical manifestations, including headache, jaw claudication, and visual symptoms, were similar across groups. Notable lab differences were seen at diagnosis. AA patients had higher ESR (79.8 vs. 58.4 mm/h, p = 0.005), while CRP levels were marginally higher in CA patients (8.4 vs. 4.7 mg/dL, p = 0.051). Hemoglobin and platelet counts were higher in CA patients (12.9 vs. 11.4 g/dL, p = 0.042) and (336 vs. 282 x10^3//μL, p = 0.047), respectively. No significant differences were observed in white blood cell (WBC) counts, relapse, or mortality.

Conclusion: Although age and clinical presentation were comparable, AA patients exhibited higher ESR and more anemia, while CA patients had marginally higher CRP and more biopsy-confirmed diagnoses. These findings may reflect biologic or system-level differences influencing disease recognition or expression. Further investigation is warranted to further clarify potential racial variations in GCA presentation and diagnostic pathways.

Table 1. Exploration of variables including baseline characteristics, presenting symptoms, rate of biopsy-proven GCA, relapse, and all cause-mortality in Caucasian versus African American patients with GCA

Table 2. Comparison of inflammatory markers and hematologic laboratory values at time of GCA diagnosis

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/exploring-racial-variation-in-the-clinical-manifestations-of-giant-cell-arteritis-a-retrospective-single-center-study/