Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2025 Jul 30;27(1):162.
doi: 10.1186/s13075-025-03594-9.

Prevalence, characteristics, and outcomes of patients with low baseline C-reactive protein in giant cell arteritis

Samuel Pichon  1 , Vincent Koether  2 , Amélie Leurs  2   3 , Aurelien Chepy  2   4 , Benoît Gachet  5   6 , Vincent Sobanski  2   4   7 , David Launay  2   4 , Marc Lambert  2 , Eric Hachulla  8
Affiliations
Observational Study

Prevalence, characteristics, and outcomes of patients with low baseline C-reactive protein in giant cell arteritis

Samuel Pichon et al. Arthritis Res Ther. .

Abstract

Objective: Elevated inflammatory markers play a crucial role in the diagnosis and follow-up of patients with giant cell arteritis (GCA). This study aimed to describe the prevalence, characteristics, and outcomes of patients with low baseline (< 10 mg/L) C-reactive protein (CRP) in GCA.

Methods: A retrospective observational study was conducted at Lille University Hospital, involving all patients diagnosed with GCA between January 2000 and April 2023. Patients were categorized based on their CRP level at diagnosis. Baseline characteristics, clinical manifestations, laboratory findings, imaging results, and outcomes were compared between patients with baseline CRP < 10 mg/L ("low CRP") and those with CRP ≥ 10 mg/L ("high CRP").

Results: Of the 380 patients, 7.6% (n = 29) had baseline CRP < 10 mg/L at diagnosis. When compared to the high CRP group, the low CRP group exhibited a lower incidence of fever, and had a higher incidence of ocular involvement, particularly anterior ischemic optic neuropathy (28% vs. 13%, p = 0.04), and limb claudication (24% vs. 8%, p < 0.01). Plasma fibrinogen levels were elevated (> 4 g/L) in 77% of patients with low CRP. Despite differences in clinical presentation, relapse rates were equilibrated between the two groups.

Conclusion: GCA patients with low CRP are not rare and present with more ocular and peripheral vascular involvement and less constitutional symptoms in our study. Elevated fibrinogen in these patients suggests active inflammation despite low CRP. Clinicians should consider GCA even with a CRP < 10 mg/L, as these patients may present with severe complications.

Keywords: Acute phase reactant; C reactive protein; Giant cell arteritis; Vasculitis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart outlining study selection
Fig. 2
Fig. 2
Relapse free survival according to CRP at baseline Kaplan-Meier curve with 95% confidence interval. 8 patients experienced a relapse in the low CRP group and 173 in the High CRP group
See this image and copyright information in PMC

References

    1. Jennette JC. Overview of the 2012 revised international chapel hill consensus conference nomenclature of vasculitides. Clin Exp Nephrol. 2013;17:603–6. 10.1007/s10157-013-0869-6. - PMC - PubMed
    1. Putman MS, Gribbons KB, Ponte C, et al. Clinicopathologic associations in a large international cohort of patients with giant cell arteritis. Arthritis Care Res. 2022;74:1013–8. 10.1002/acr.24540. - PubMed
    1. Penet T, Lambert M, Baillet C, et al. Giant cell arteritis-related cerebrovascular ischemic events: a French retrospective study of 271 patients, systematic review of the literature and meta-analysis. Arthritis Res Ther. 2023;25:116. 10.1186/s13075-023-03091-x. - PMC - PubMed
    1. Hellmich B, Agueda A, Monti S, et al. 2018 update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020;79:19–30. 10.1136/annrheumdis-2019-215672. - PubMed
    1. Ponte C, Grayson PC, Robson JC, et al. 2022 American college of rheumatology/eular classification criteria for giant cell arteritis. Arthritis Rheumatol. 2022;74:1881–9. 10.1002/art.42325. - PubMed

Publication types