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Ab0465 analysis of vasculitis patterns in patients with giant cell arteritis compared to patients with giant cell arteritis and polymyalgia rheumatica

Annals of the Rheumatic Diseases(2020)

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Abstract
Background:Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) often coexist.1The role of modern ultrasound in diagnosis of GCA as well as PMR is well known.2To date it is unknown, whether patients with GCA and PMR have a different vasculitis pattern in ultrasound (US) examination than patients with GCA only.Objectives:To prospectively identify differences in vasculitis patterns in consecutive patients with newly diagnosed GCA and PMR compared to newly diagnosed GCA patients without PMR.Methods:US examination of the arteries typically affected in GCA, such as axillary arteries, vertebral arteries, superficial temporal arteries with both frontal and parietal branches and facial arteries was performed in patients with GCA and PMR (GCA-PMR-group) as well as in patients with GCA only (GCA-group) at time of first diagnosis. Arteries were defined as pathological, if measured intima-media-thickness by US was above respective cut-off values.3Results:The GCA-PMR-group consisted of 27 patients, the GCA-group of 18 patients. In the GCA-PMR-group, a total of 206 arteries were affected, while in the GCA-group 131 arteries were affected. Mean age and gender distribution was 74 years (SD± 9) with 10 (37%) females in the GCA-PMR-group and 76 years (SD± 9) with 10 (55%) females in the GCA-group. Median values of C-reactive protein (CRP) were 57.2 (IQR 31.7-75.7) in the GCA-group and 48.3 (IQR 17.5- 79.9) in the GCA-PMR-group, no significance was observed (p= 0.3577). Mean number of affected arteries per patient was 7.63 and 7.28 in the GCA-PMR-group and GCA-group, respectively. Altogether, no significant difference in vascular pattern between the two groups was observed. Exact numbers, distribution and IMT-values for all measured arteries are depicted in table 1.Conclusion:In our cohort, we did not observe a significant difference in vascular patterns between patients with GCA and PMR and GCA only patients.References:[1]Salvarani C, Cantini F, Hunder GG. Polymyalgia rheumatica and giant-cell arteritis. The Lancet 2008;372:234–45.[2]Dejaco C, Ramiro S, Duftner C, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis 2018;77:636–43.[3]Schäfer VS, Juche A, Ramiro S, Krause A, Schmidt WA. Ultrasound cut-off values for intima-media thickness of temporal, facial and axillary arteries in giant cell arteritis. Rheumatology (Oxford) 2017;56:1479–83.Disclosure of Interests:None declared
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Key words
giant cell arteritis,vasculitis patterns,polymyalgia rheumatica
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