Ultrasonographic Halo Score May Signal Complication Among Patients With GCA

The ultrasonographic Halo Score may help identify patients with giant cell arteritis (GCA) with intimal hyperplasia, a temporal artery biopsy feature associated with ischemic sight loss, according to a study published in Rheumatology.

“Thus, Halo Scores may identify a subset of GCA patients with intimal hyperplasia and high rates of ischemic sight loss,” researchers wrote.

The study included 90 patients with suspected GCA who underwent ultrasonography of temporal/axillary arteries and a temporal artery biopsy. Among them, 27 patients had a temporal artery biopsy that an experienced pathologist deemed positive for GCA at baseline. Another 32 patients with a negative biopsy result received a clinical diagnosis of GCA after 6 months of follow-up.

Halo Scores were higher in patients with a positive temporal artery biopsy, according to the study. Patients with a positive temporal artery biopsy as well as intimal hyperplasia had the most extensive arterial wall swelling on ultrasound, as reflected in elevated Halo Scores. Among patients with a positive temporal artery biopsy, the Halo Score discriminated well between those with and without intimal hyperplasia, researchers reported.

Patients with a positive temporal artery biopsy and intimal hyperplasia presented more frequently with ischemic sight loss (40%) compared with other patients with GCA (between 13% and 14%), the study found.

“Further studies are needed to evaluate the ability of ultrasonography to detect arterial inflammation in the absence of intimal hyperplasia,” researchers advised.

—Jolynn Tumolo

Reference

van der Geest KSM, Wolfe K, Borg F, et al. Ultrasonographic Halo Score in giant cell arteritis: association with intimal hyperplasia and ischaemic sight loss. Rheumatology. 2021;60(9):4361-4366.