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Large-vessel vasculitis

 

Follow-up vascular ultrasounds in patients with giant cell arteritis


1, 2, 3, 4, 5, 6

 

  1. Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Boston, and Harvard Medical School, Boston, MA, USA.
  2. Harvard Medical School, Boston, MA, USA.
  3. Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Boston, MA, USA.
  4. Harvard Medical School, Boston, and Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, MA, USA.
  5. Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Boston, and Harvard Medical School, Boston, MA, USA.
  6. Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Boston, and Harvard Medical School, Boston, MA, USA. stedeschi1@bwh.harvard.edu

CER12928
2020 Vol.38, N°2 ,Suppl.124
PI 0107, PF 0111
Large-vessel vasculitis

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PMID: 32359038 [PubMed]

Received: 07/11/2019
Accepted : 06/04/2020
In Press: 27/04/2020
Published: 21/05/2020

Abstract

OBJECTIVES:
Literature describing follow-up vascular ultrasound (VUS) in giant cell arteritis (GCA) is limited. We report our experience with follow-up VUS obtained in clinical care of patients with GCA.
METHODS:
We retrospectively identified GCA patients with an abnormal initial VUS, defined as circumferential hypoechoic wall thickening (“halo sign”), or circumferential hyperechoic wall thickening without evidence of arteriosclerosis or arteritis, who subsequently underwent follow-up VUS during 2013-2018. Studies were interpreted as active arteritis, hyperechoic wall thickening without active arteritis, or no arteritis. We compared clinical and laboratory characteristics at time of initial VUS among patients with active arteritis vs. hyperechoic wall thickening without active arteritis. We described whether and how VUS interpretation changed from initial to follow-up VUS. Among individual vessels, we tested whether abnormal findings (e.g. halo sign) persisted at follow-up VUS using McNemar’s test.
RESULTS:
42 patients fulfilled study criteria. Median time between initial and follow-up VUS was 5.1 (IQR 2.6-7.9) months. Characteristics at initial VUS did not differ according to VUS interpretation. Among 36 patients with active arteritis on initial VUS, follow-up VUS showed active arteritis in 25.0%, hyperechoic wall thickening in 33.3% and no arteritis in 41.7%. Among 6 patients with hyperechoic wall thickening on initial VUS, half had no arteritis on follow-up VUS. Sonographic findings tended to persist in axillary arteries and were more likely to change in the superficial temporal arteries.
CONCLUSIONS:
Among 42 GCA patients, the majority had a change in VUS interpretation between initial and follow-up VUS. Sonographic findings in the temporal circulation more frequently changed than findings in axillary arteries.

Rheumatology Article