Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Large-Vessel Involvement in Newly-Diagnosed Giant Cell Arteritis: A Case-Control Study Using Color-Doppler Sonography.

Ghinoi1,  Alessandra, Boiardi1,  Luigi, Pipitone1,  Nicolò, Restuccia1,  Giovanna, Nicolini1,  Alberto, Silingardi1,  Mauro, Germano1,  Giuseppe

Arcispedale S Maria Nuova, Reggio Emilia, Italy
Arcispedale S Maria Nuova, Reggia Emilia, Italy

Purpose:

The prevalence of large-vessel vasculitis (LVV) in newly diagnosed giant cell arteritis (GCA) is still poorly documented. Two studies have estimated such prevalence at 30% and 83% using Color-doppler sonograhy (CDS) (1) and 18F-FDG PET (fluoroxedoxyglucose positron emission tomography) (2), respectively. CDS allows to visualize the temporal, axillary, and subclavian arteries, as well as the aortic arch, abdominal aorta and supra-aortic vessels. The presence of a hypoechoic halo around the arterial walls is considered quite specific for GCA.

The aim of this study was to investigate the prevalence of LVV in newly diagnosed GCA using CDS and to compare the clinical findings of GCA patients with and without LVV.

Methods:

Sixty-two consecutive patients with a diagnosis of new-onset GCA according to the American College of Rheumatology criteria who had a CDS performed were analyzed. The identified patients with LVV were randomly matched to an equal number of GCA patients without LVV.

Results:

In 19 out of 62 patients (30.6%), CDS showed the characteristic halo sign in at least one vessel examined. Comparing patients with and without LVV, no significant difference was found for any of the following parameters: gender (male:female 0.0/100% versus 21.1%/78.9%), positivity of the temporal artery biopsy (82.4% versus 88.2%), presence of a transmural infiltrate (78.6% versus 86.7%) or periadventitial infiltrate (21.4% versus 13.3%), temporal arteries' abnormalities on inspection (85.7% versus 92.3%), cranial (77.8% versus 94.1%) and constitutional (66.7% versus 35.3%) manifestations. Similarly, the ESR was similar in both groups (91±30 versus 72±25 mm/1st hour).

Conclusion:

LVV evidenced by CDS occurred in 30.6% pts with newly diagnosed GCA. This prevalence is very similar to that found in a previous study with a similar design. Constitutional manifestations were more frequent and cranial manifestations were less frequent in our GCA patients with LVV, although the difference did not reach significance. Early diagnosis of LVV in GCA can help tailor treatment accordingly and may prevent vascular complications.

References:

·SchmidtSeifertGromnica-IhleKrauseNatusch, WAAEAA. Ultrasound of proximal upper extremity arteries to increase the diagnostic yield in large-vessel giant cell arteritis. Rheumatology 2008 Jan;47(1):96–101.

·Blockmansde CeuninckVanderschuerenKnockaertMortelmansBobbaers, DLSDLH. Repetitive 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a prospective study of 35 patients.Arthritis Rheum 2006 Feb;15;55(1):131–7.

To cite this abstract, please use the following information:
Ghinoi, Alessandra, Boiardi, Luigi, Pipitone, Nicolò, Restuccia, Giovanna, Nicolini, Alberto, Silingardi, Mauro, et al; Large-Vessel Involvement in Newly-Diagnosed Giant Cell Arteritis: A Case-Control Study Using Color-Doppler Sonography. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1302
DOI: 10.1002/art.29068

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