Should Ultrasonographic Giant-Cell Arteritis Signs be Detected in Patients with Polymyalgia Rheumatica?
DOI:
https://doi.org/10.31964/mltj.v7i1.344Keywords:
Giant cell arteritis, polymyalgia rheumatica, ultrasonographyAbstract
Based on the presence of ultrasonographic findings of Giant-Cell Arteritis in Polymyalgia Rheumatica patients using Ultrasonography on the temporal artery, the study contributes to the literature evaluating the unclear relationship between Polymyalgia Rheumatica and Giant-Cell Arteritis. It raises awareness that Ultrasonography can be used instead of biopsy in patients with suspected Giant-Cell Arteritis. Twenty patients were newly diagnosed with Polymyalgia Rheumatica and included 20 participants as a control group in the study. The Polymyalgia Rheumatica group was evaluated at baseline and sixth month, while the control group was only assessed at baseline. Laboratory, clinical, and ultrasonographic findings of all participants were assessed. Gray-scale Ultrasonography and colored Doppler Ultrasonography were used to present halo and compression, occlusion, and stenosis in addition to intima-media complex thickness in bilateral temporal arteries and frontal-parietal branches by an experienced radiologist blinded to the subject. No significant difference was found between Polymyalgia Rheumatica and control groups based on demographic features, clinical and ultrasonographic results at baseline and sixth month. Erythrocyte sedimentation rate of Polymyalgia Rheumatica at baseline was statistically higher than the control group. Erythrocyte sedimentation rate values have declined significantly in Polymyalgia Rheumatica patients, but no significant changes were found for clinical or ultrasonographic features during the sixth month. Ultrasonographic findings of Giant-Cell Arteritis are not present in newly diagnosed and six months followed up Polymyalgia Rheumatica patients. Further studies are needed.References
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De Miguel, E., Roxo, A., Castillo, C., Peiteado, D., Villalba, A., & Martín-Mola, E. (2012). The utility and sensitivity of colour Doppler ultrasound in monitoring changes in giant cell arteritis. Clin Exp Rheumatol, 30(1 Suppl 70), S34-8.
Ulusoy H, Sarıca N, Arslan Ş. (2009). Polymyalgia Rheumatica and Giant Cell Arteritis: A Case Report and Review of Literature. Turkish Journal of Physical Medicine and Rehabilitation, 55, 45-49.
Schmidt, W. A. (2018). Ultrasound in the diagnosis and management of giant cell arteritis. Rheumatology, 57(suppl_2), ii22-ii31.
Buttgereit, F., Dejaco, C., Matteson, E. L., & Dasgupta, B. (2016). Polymyalgia rheumatica and giant cell arteritis: a systematic review. Jama, 315(22), 2442-2458.
Shoenfeld, Y., Cervera, R., & Gershwin, M. E. (Eds.). (2010). Diagnostic criteria in autoimmune diseases. Springer Science & Business Media.
Dejaco, C., Brouwer, E., Mason, J. C., Buttgereit, F., Matteson, E. L., & Dasgupta, B. (2017). Giant cell arteritis and polymyalgia rheumatica: current challenges and opportunities. Nature Reviews Rheumatology, 13(10), 578.
Dasgupta, B., Cimmino, M. A., Kremers, H. M., Schmidt, W. A., Schirmer, M., Salvarani, C., ... & Duhaut, P. (2012). 2012 provisional classification criteria for polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Arthritis & Rheumatism, 64(4), 943-954.
Schäfer, V. S., Juche, A., Ramiro, S., Krause, A., & Schmidt, W. A. (2017). Ultrasound cut-off values for intima-media thickness of temporal, facial, and axillary arteries in giant cell arteritis. Rheumatology, 56(9), 1479-1483.
Gonzalez-Gay, M. A. (2004, April). Giant cell arteritis and polymyalgia rheumatica: two different but often overlapping conditions. In Seminars in arthritis and rheumatism (Vol. 33, No. 5, pp. 289-293). WB Saunders.
Dejaco, C., Duftner, C., Buttgereit, F., Matteson, E. L., & Dasgupta, B. (2017). The spectrum of giant cell arteritis and polymyalgia rheumatica: revisiting the concept of the disease. Rheumatology, 56(4), 506-515.
Brack, A., Martinez‐Taboada, V., Stanson, A., Goronzy, J. J., & Weyand, C. M. (1999). Disease pattern in cranial and large‐vessel giant cell arteritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 42(2), 311-317.
Diamantopoulos, A. P., Haugeberg, G., Hetland, H., Soldal, D. M., Bie, R., & Myklebust, G. (2014). Diagnostic value of color Doppler ultrasonography of temporal arteries and large vessels in giant cell arteritis: a consecutive case series. Arthritis care & research, 66(1), 113-119.
Roth, A. M., Milsow, L., & Keltner, J. L. (1984). The ultimate diagnoses of patients undergoing temporal artery biopsies. Archives of Ophthalmology, 102(6), 901-903.
Hall, S. S. J. P. L. G., Lie, J. T., Kurland, L. T., Persellin, S., O'Brien, P. C., & Hunder, G. G. (1983). The therapeutic impact of temporal artery biopsy. The Lancet, 322(8361), 1217-1220.
Luqmani, R., Lee, E., Singh, S., Gillett, M., Schmidt, W. A., Bradburn, M., ... & Masters, S. (2016). The role of ultrasound compared to the biopsy of temporal arteries in diagnosing and treating giant cell arteritis (TABUL): a diagnostic accuracy and cost-effectiveness study. Health Technol. Assess, 20,1–238.
Porto, S. A. G., Díaz, M. T. S., Arias, A. R., Otero, J. P., Rodríguez, A. G., Gasalla, J. V., & de Toro Santos, F. J. (2020). A comparative study of Doppler ultrasound against temporal artery biopsy in the diagnosis of giant cell arteritis. Reumatología Clínica (English Edition), 16(5), 313-318.
Schmidt, W., Kraft, H., Völker, L., Vorpahl, K., & Gromnica-Ihle, E. (1995). Colour Doppler sonography to diagnose temporal arteritis. The Lancet, 345(8953), 866.
Karahaliou, M., Vaiopoulos, G., Papaspyrou, S., Kanakis, M. A., Revenas, K., & Sfikakis, P. P. (2006). Colour duplex sonography of temporal arteries before the biopsy decision: a prospective study in 55 patients with suspected giant cell arteritis. Arthritis research & therapy, 8(4), R116.
Habib, H. M., Essa, A. A., & Hassan, A. A. (2012). Color duplex ultrasonography of temporal arteries: role in diagnosis and follow-up of suspected cases of temporal arteritis. Clinical rheumatology, 31(2), 231-237.
De Miguel, E., Roxo, A., Castillo, C., Peiteado, D., Villalba, A., & Martín-Mola, E. (2012). The utility and sensitivity of colour Doppler ultrasound in monitoring changes in giant cell arteritis. Clin Exp Rheumatol, 30(1 Suppl 70), S34-8.
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Published
2021-06-18
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Kulaklı, F., Sari, İlker F., Çaylı, E., & Çilesizoğlu Yavuz, N. (2021). Should Ultrasonographic Giant-Cell Arteritis Signs be Detected in Patients with Polymyalgia Rheumatica?. Medical Laboratory Technology Journal, 7(1), 10–17. https://doi.org/10.31964/mltj.v7i1.344
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