Clinical, Laboratory and Ultrasonographic Interrelations in Giant Cell Arteritis.
OBJECTIVES
The diagnosis of giant cell arteritis (GCA) is based on the presence of clinical and laboratory features. Color-duplex sonography (CDS) may supplant the limited sensitivity of temporal artery biopsy. The aim of our work was to characterize clinical and laboratory findings in patients with positive CDS for GCA.


MATERIALS AND METHODS
Retrospective study of all consecutive patients of our center fulfilling American College of Rheumatology criteria for GCA who performed CDS study between 2009-2019. Data on clinical and laboratory features were compared in two groups: with and without halo sign.


RESULTS
Ninety-one patients were included. Temporal halo sign was identified in 46% of patients. Halo sign was more often present in older patients (77 ± 8 vs 73 ± 8 years, p = 0.022), associated with systemic features (58% vs 42%, p = 0.011), higher erythrocyte sedimentation rate (84 ± 26 vs 74 ± 34 mm/hour, p = 0.020), and lower hemoglobin values (10.9 ± 1.5 vs 12.1 ± 1.6 g/dL, p < 0.001). The number of patients under corticosteroids before CDS was higher in the group without halo (62% vs 33%, p = 0.005). Ischemic stroke occurred in 17 patients (19%), 76% in the vertebrobasilar territory, and stroke was associated with vertebral halo sign (p < 0.001).


CONCLUSIONS
Halo sign was present in half of our patients. Previous corticosteroids treatment decreased positive CDS findings. Systemic symptoms and laboratory findings are more notorious in halo sign subgroup of patients. Stroke cases in GCA patients disproportionally affected the posterior circulation. Ultrasonography provides information about a more pronounced systemic involvement and a higher risk of major complications.
['Soares|Carolina|C|', 'Costa|Andreia|A|', 'Santos|Rosa|R|', 'Abreu|Pedro|P|', 'Castro|Pedro|P|', 'Azevedo|Elsa|E|']
D000305:Adrenal Cortex Hormones D000368:Aged D000369:Aged, 80 and over D001706:Biopsy D005260:Female D013700:Giant Cell Arteritis D006801:Humans D000083242:Ischemic Stroke D008297:Male D011237:Predictive Value of Tests D012189:Retrospective Studies D013699:Temporal Arteries D018615:Ultrasonography, Doppler, Color D017585:Ultrasonography, Doppler, Transcranial
Giant cell arteritis Color-duplex sonography Halo sign Stroke Systemic symptoms