More information about text formats
We read with interest the editorial by Miller which comments on the
paper, ‘Epidemiology of giant-cell arteritis in an Arab population: a 22-year study’. The author of the editorial comments on geographical
variation in the incidence of giant cell arteritis and cites evidence
supporting both genetic and environmental aetiologies.
We re-examined the data from our 5 year study looking at...
We re-examined the data from our 5 year study looking at biopsy
proven giant cell arteritis at Leicester Royal Infirmary and identified
the ethnicity of the patients. This unit is the only tertiary ophthalmic
referral centre for the county of Leicestershire, United Kingdom. Census
data from 2001 indicates that ethnic Asians in Leicestershire make up 30%
of the population. Out of a total of 42 biopsies, only 3 cases (7.1%) were
from patients of Asian ethnicity. Whilst our study was not a prospective
population based study, the data lends weight to the idea that GCA is
relatively rare in ethnic Asians.
Interestingly our findings differ from those of Lam et al who found
the prevalence of GCA to be similar in Hispanic and non-Hispanic patients.
Inferences can be made about the aetiology of a disease by examining the
incidence of a disease in migrant populations when the direction of
migration is from an area of low incidence to an area of high incidence.
For example, the incidence of multiple sclerosis in Indian and Pakistani
migrants to the UK has been studied and it has been found that migration
prior to the age of 15 years confers an increased risk of developing
multiple sclerosis, a finding which implicates environmental agents.
Similar prospective studies looking at the relationship between age at
migration and risk of developing GCA may yield more information about the
interplay between genetic and environmental factors.
1. Miller NR. Epidemiology of giant cell arteritis in an Arab
population: a 22-year study. Br J Ophthalmol. 2007 Jun;91(6):705-6.
2. Jain S, Shah A, Deane J. Giant cell arteritis. (letter).
Ophthalmology. 2007 Jun;114(6):1235
3. Lam BL, Wirthlin RS, Gonzalez A, Dubovy SR, Feuer WJ. Giant cell
arteritis among Hispanic Americans. Am J Ophthalmol. 2007 Jan;143(1):161-3
4. Dean G, Elian M. Age at immigration to England of Asian and
Caribbean immigrants and the risk of developing multiple sclerosis. J
Neurol. Neurosurg. Psychiatry 1997;63:565-568