I treat empirically. Having said that, the local rheumatology
department have set up a rapid access TA diagnostic clinic recently
where they arrange speedy biopsies.
Historically people seem to get followed up forever in out-patients
(unless I actively encourage them to let me follow them up) if they
get to secondary care.
Russell
2008/5/6 Saul Galloway <[log in to unmask]>:
> 75 year old lady comes in today with 1 month malaise, anorexia, achy head
> and face, tender lumpy temples, occasional swollen tongue. I put her 30mg
> pred/day and send off FBC, ESR and CRP expecting it to be TA. If the
> inflammatory markers are suitably sky high is the consensus to simply treat
> without biopsy? I'm thinking if ESR/CRP is just moderately elevated I'm
> still tempted to treat with prolonged steroid (:-( type 2 DM as well, so now
> I'm thinking the inflam markers are only "helpful" if normal, but then I
> read 2-9% of TA has a normal ESR so...
>
> What do you do?
>
> -----Original Message-----
> From: GP-UK [mailto:[log in to unmask]] On Behalf Of Ahmad Risk
> Sent: 11 April 2008 10:26
> To: [log in to unmask]
> Subject: CKS beta site
>
> You may already know of the Clinical Knowledge Summaries Service (CKS) at
> <http://cks.library.nhs.uk>
>
> We have posted a new beta website at <http://beta.cks.library.nhs.uk>
>
> All feedback, thoughts and suggestions are welcome. Please hammer it as
> much as you can and send your feedback through the [conatct us] form on
> the site.
>
> Thank you
>
> Ahmad Risk
> Clinical Editor
>
>
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