Atherosclerosis as a potential pitfall in the diagnosis of giant cell arteritis

Abstract Objectives To explore whether the increase in the intima-media thickness (IMT) in arteriosclerotic disease correlates with the increase in the IMT in temporal arteries (TAs) and if that could mimic the US GCA halo sign. Methods Consecutive patients ⩾50 years old with high vascular risk and...

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Published in:Rheumatology (Oxford, England) England), 2018-02, Vol.57 (2), p.318-321
Main Authors: De Miguel, Eugenio, Beltran, Luis M, Monjo, Irene, Deodati, Francesco, Schmidt, Wolfgang A, Garcia-Puig, Juan
Format: Article
Language:English
Subjects:
Aged
Arteries
Arteriosclerosis
Arteritis
Atherosclerosis
Atherosclerosis - diagnostic imaging
Autoimmune diseases
Carotid Arteries - diagnostic imaging
Carotid Intima-Media Thickness
Diagnosis
Diagnosis, Differential
Female
Giant Cell Arteritis - diagnostic imaging
Humans
Male
Medical diagnosis
Middle Aged
Reference Values
Statins
Temporal Arteries - diagnostic imaging
Ultrasonography, Doppler, Color
Vein & artery diseases
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Summary:Abstract Objectives To explore whether the increase in the intima-media thickness (IMT) in arteriosclerotic disease correlates with the increase in the IMT in temporal arteries (TAs) and if that could mimic the US GCA halo sign. Methods Consecutive patients ⩾50 years old with high vascular risk and without signs or symptoms of GCA were included. The carotid US IMT measurements were obtained using a standardized software radiofrequency-tracking technology. Colour Doppler US and grey-scale measurements of the IMT in the branches of both TAs were performed by a second sonographer using a 22 MHz probe. Results Forty patients were studied (28 men) with a mean age of 70.6 years. The carotid IMT exhibited significant correlation with the TA IMT. A carotid IMT >0.9 mm was associated with a temporal IMT >0.3 mm. Only one patient had an IMT >0.34 mm in two branches. Conclusions Atherosclerotic disease with a carotid IMT >0.9 mm increases the TA IMT and might mimic the halo sign. As atherosclerosis is common in this age group, we propose a cut-off of TA IMT >0.34 mm in at least two branches to minimize false positives in a GCA diagnosis.
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/kex381