ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2753

Extension of Extracranial Vessel Involvement in Patients with Giant Cell Arteritis

Monica Calderón Goercke1, Javier Loricera2, Diana Prieto Peña1, Francisco Javier Narváez3, Elena Aurrecoechea4, Ignacio Villa-Blanco5, Santos Castañeda6, Catalina Gómez-Arango7, Antonio Mera8, Eva Perez Pampín8, Vicente Aldasoro9, Noelia Álvarez-Rivas10, Nagore Fernandez-Llanio Cornella11, Maria Concepcion Alvarez de Buergo12, Luisa Marena Rojas Vargas13, Francisca Sivera14, Eva Galindez-Agirregoikoa15, Roser Solans16, Susana Romero-Yuste17, Norberto Ortego Centeno18, Marcelino Revenga Martínez19, Rafael Melero20, Eva Salgado-Pérez21, Sabela Fernández22, José Luis Martín-Varillas23, Isabel Martínez-Rodríguez24, Ignacio Banzo24, Vanesa Calvo-Río23, Belén Atienza-Mateo23, Natalia Palmou-Fontana23, Carmen González-Vela25, José Luis Hernández2, Miguel Angel González-Gay23 and Ricardo Blanco23, 1Rheumatology, Rheumatology. Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 2Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 3Rheumatology Department, Hospital de Bellvitge. Barcelona. Spain, L’Hospitalet de Llobregat, Spain, 4Rheumatology, Hospital de Sierrallana. Torrelavega. Spain, Torrelavega, Spain, 5Hospital de Sierrallana. Torrelavega. Spain, Torrelavega, Spain, 6Rheumatology, Rheumatology Department, Hospital Universitario la Princesa, IIS-Princesa, Madrid, Spain, 7Hospital Alto Deba, Mondragón. Spain, Mondragón, Spain, 8Rheumatology Division. Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain, 9Hospital Alto Deba. Mondragón. Spain, Mondragon, Spain, 10Hospital Universitario Lucus Augusti, Lugo. Spain, Lugo, Spain, 11Rheumatology Section. Hospital Arnau de Vilanova, Valencia, Spain, 12Rheumatology, Hospital Río Carrión. Palencia. Spain, Palencia, Spain, 13Rheumatology Department, Hospital General La Mancha Centro, Alcázar de San Juan, Spain, 14Rheumatology, Hospital General Universitario de Elda. Comunidad Valenciana. Spain, Elda, Spain, 15Rheumatology Division, Hospital Universitario de Basurto, Bilbao, Spain, 16Autoimmune Systemic Diseases Unit, Department of Internal Medicine, Hospital Vall d'Hebron, Autonomous University of Barcelona, Spain, Barcelona, Spain, 17Hospital de Pontevedra. Spain, Pontevedra, Spain, 18Medicine Department, Hospital Universitario San Cecilio. Granada. Spain, Granada, Spain, 19Hospital Universitario Ramón y Cajal. Madrid. Spain, Madrid, Spain, 20Rheumatology, Complexo Hospitalario Universitario de Vigo, Vigo. Spain, Vigo, Spain, 21Rheumatology, Complejo Hospitalario Universitario de Ourense, Ourense. Spain, Ourense, Spain, 22Rheumatology, Hospital Universitario San Agustín, Avilés. Spain, Avilés, Spain, 23Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 24Nuclear Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 25Pathology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: ,

Session Information

Date: Tuesday, October 23, 2018

Title: Vasculitis Poster III: Immunosuppressive Therapy in Giant Cell Arteritis and Polymyalgia Rheumatica

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: Giant cell arteritis (GCA) is a large vessel vasculitis with a predisposition for the cranial branches of the external carotid artery. However, aorta and / or its main branches may also be involved (1-4). In a series of patients with GCA who presented extracranial vessel involvement, our aim was to assess a) the vascular territories most frequently affected and b) correlation of a major extension of extracranial vascular involvement with a more severe clinical and analytical features.

Methods: Multicenter study of 68 patients with GCA who presented a compromise of extracranial vessels confirmed by PET/CT. Visual analysis of vascular uptake was performed on supra-aortic trunks (SAT), aortic arch (AA), thoracic aorta (TA), abdominal aorta (AA), iliac arteries (IA), lower limb arteries (LLA), and upper limb arteries (ULA).

 

Results: We evaluated 68 patients with GCA (51w/17m) with a mean age of 68.0±8.3 years. The vascular territories affected were: TA (n=58, 85.29%), SAT (n=38, 55.88%), AA (n=28, 41.18%), AA (n=18, 26.47%), LLA (n=17, 25%), IA (n=13, 19.12%) and ULA (n=6, 8.82%). We considered 3 groups according to the number of vascular territories affected: a) 1 or 2 territories, b) 3 or 4 territories and c) 5 or more territories and made a comparative study between this groups. In patients with ³5 vascular territories affected, we observed a higher baseline ESR, and the most frequent systemic manifestations were polymyalgia rheumatica and constitutional symptoms with statistical significance (TABLE). Distribution of categorical variables was compared by the Pearson Chi-squared test. Quantitative variables were analyzed using the ANOVA test.

 

Conclusion: In patients with GCA the involvement of TA is very frequent, followed by the SAT and the AA. Regarding the laboratory findings, patients with higher levels of ESR presented a major extension of extracranial vascular involment, as well as presenting PMR and/or constitutional symptoms was also related to more affection of extracranial territories.

 

 

 

NUMBER OF VASCULAR TERRITORIES AFFECTED

p

ACUTE PHASE REACTANTS

1-2

3-4

³5

 

CRP, mg/dL mean (SD)

3.1 ± 1.0

5.4 ± 1.8

7.3 ± 3.2

0.315

ESR, mm/1st hour, mean (SD)

36.8 ± 5.3

44.4 ± 6.2

74.5 ± 13.0

0.031

Hemoglobin, g/dL, mean (SD)

12.4 ± 0.2

12.0 ± 0.4

11.6 ± 0.5

0.438

SYSTEMIC MANIFESTATIONS

 

 

 

 

Constitutional syndrome, n (%)

6 (17.1)

6 (22.2)

5 (83.3)

0.002

PMR, n (%)

28 (52.9)

23 (85.2)

4 (66.7)

0.03

ISCHEMIC MANIFESTATIONS

 

 

 

 

Headache, n (%)

11 (31.4)

10 (37)

2 (33.3)

0.898

Jaw claudication, n (%)

1 (2.9)

3 (11.1)

1 (16.7)

0.307

Visual involvement, n (%)

2 (5.7)

2 (7.4)

–

0.783

 

Disclosure: M. Calderón Goercke, None; J. Loricera, None; D. Prieto Peña, None; F. J. Narváez, None; E. Aurrecoechea, None; I. Villa-Blanco, None; S. Castañeda, None; C. Gómez-Arango, None; A. Mera, None; E. Perez Pampín, None; V. Aldasoro, None; N. Álvarez-Rivas, None; N. Fernandez-Llanio Cornella, None; M. C. Alvarez de Buergo, None; L. M. Rojas Vargas, None; F. Sivera, None; E. Galindez-Agirregoikoa, None; R. Solans, None; S. Romero-Yuste, None; N. Ortego Centeno, None; M. Revenga Martínez, None; R. Melero, None; E. Salgado-Pérez, None; S. Fernández, None; J. L. Martín-Varillas, None; I. Martínez-Rodríguez, None; I. Banzo, None; V. Calvo-Río, None; B. Atienza-Mateo, None; N. Palmou-Fontana, None; C. González-Vela, None; J. L. Hernández, None; M. A. González-Gay, None; R. Blanco, None.

To cite this abstract in AMA style:

Calderón Goercke M, Loricera J, Prieto Peña D, Narváez FJ, Aurrecoechea E, Villa-Blanco I, Castañeda S, Gómez-Arango C, Mera A, Perez Pampín E, Aldasoro V, Álvarez-Rivas N, Fernandez-Llanio Cornella N, Alvarez de Buergo MC, Rojas Vargas LM, Sivera F, Galindez-Agirregoikoa E, Solans R, Romero-Yuste S, Ortego Centeno N, Revenga Martínez M, Melero R, Salgado-Pérez E, Fernández S, Martín-Varillas JL, Martínez-Rodríguez I, Banzo I, Calvo-Río V, Atienza-Mateo B, Palmou-Fontana N, González-Vela C, Hernández JL, González-Gay MA, Blanco R. Extension of Extracranial Vessel Involvement in Patients with Giant Cell Arteritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/extension-of-extracranial-vessel-involvement-in-patients-with-giant-cell-arteritis/. Accessed .

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