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The Incidence of Giant Cell Arteritis in Olmsted County, Minnesota: Apparent Fluctuations in a Cyclic Pattern

Carlo Salvarani; Sherine E. Gabriel; W. Michael O'Fallon; and Gene G. Hunder
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From Mayo Clinic and Mayo Foundation, Rochester, Minnesota. Requests for Reprints: Sherine E. Gabriel, MD, MSc, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905. Acknowledgments: The authors thank Mr. Eric Metz for assistance with statistical analysis and Ms. Lori Norby for assistance in manuscript preparation. Grant Support: In part by research grant AR 30582 from the National Institutes of Health, United States Public Health Service.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1995;123(3):192-194. doi:10.7326/0003-4819-123-3-199508010-00006
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Objective: To investigate trends in the incidence of giant cell arteritis over a 42-year period in Olmsted County, Minnesota.

Design: Population-based incidence study.

Setting: Olmsted County, Minnesota.

Methods: All incidence cases of giant cell arteritis first diagnosed between 1950 and 1991 were identified using the unified record system at Mayo Clinic. Age- and sex-specific incidence rates were calculated using the number of incidence cases as the numerator and population estimates as the denominator. Overall rates were age-and sex-adjusted to the 1980 United States white population. The annual incidence rates were graphically illustrated using a 3-year centered moving average.

Results: Between 1950 and 1991, 125 Olmsted County residents (103 women and 22 men) were diagnosed with giant cell arteritis. The age- and sex-adjusted incidence per 100 000 persons 50 years of age or older was 17.8 (95% CI, 14.7 to 21.0); incidence was significantly higher in women (24.2 [CI, 19.5 to 28.9]) than in men (8.2 [CI, 4.8 to 11.6]). Age-specific incidence rates increased with age (P < 0.0001). The annual incidence rates increased significantly over the study period (P = 0.002) and appear to have clustered in five peak periods, which occurred about every 7 years. A significant calendar-time effect was identified; it predicted an increase in incidence of 2.6% (CI, 0.9% to 4.3%) every 5 years.

Conclusions: Our observation of a regular cyclic pattern in incidence rates over time supports the hypothesis of an infectious cause for giant cell arteritis. Similar studies in other populations are needed to confirm our findings.


Grahic Jump Location
Figure 1.
Annual incidence rates of giant cell arteritis in Olmsted County, Minnesota, per 100 000 persons 50 years of age or older.

Rates were calculated using a centered 3-year moving average.

Grahic Jump Location




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