ABSTRACT
Large vessel vasculitis and particularly Temporal Arteritis are systemic diseases that may affect the aorta and its major branches, mainly involving extra cranial branches of the carotid artery. We report a 72-year-old man presenting with weight loss, fever and malaise. Positron emission computed tomography (PET CT) showed an extensive inflammation of the aorta and its major branches. Temporal artery biopsy confirmed the presence of vasculitis with granulomas. Treatment with a high dose of steroids had an excellent clinical response. This case underscores the utility of PET CT in the assessment of this disease.
Subject(s)
Humans , Male , Aged , Aortitis/pathology , Aortitis/diagnostic imaging , Giant Cell Arteritis/pathology , Giant Cell Arteritis/diagnostic imaging , Aortitis/drug therapy , Temporal Arteries/pathology , Giant Cell Arteritis/drug therapy , Biopsy , Positron Emission Tomography Computed TomographyABSTRACT
Pauci-immune glomerulonephritis in systemic vasculitides usually have anti-neuthrophil cytoplasmic antibodies (ANCA). However, vasculitides of large vessels such as Takayasu’s and giant cell (temporal) arteritis do not. Exceptionally ANCA(+) small vessel vasculitides are associated with large vessel vasculitis. It may be a coincidence or both vasculitides have a common pathogenesis. We report a 30 years old woman on hemodialysis due to a chronic glomerulonephritis ANCA(+) diagnosed nine years ago. Eight years later, she presented with an aortitis with severe stenosis of distal aorta and vasculitis of left subclavian artery. She was treated with adrenal steroids and cyclophosphamide. During the ensuing five years she has been stable and without signs of reactivation of the disease.
Subject(s)
Adult , Female , Humans , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy , Aortic Valve Stenosis/drug therapy , Aortitis/drug therapy , Cyclophosphamide/therapeutic use , Steroids/therapeutic use , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications , Aortic Valve Stenosis/diagnosis , Aortitis/diagnosis , Renal Insufficiency/complications , Takayasu Arteritis/drug therapyABSTRACT
Nowadays, infectious aortitis has become a rare disease thanks to antibiotics, but remains life-threatening. We present a case of a patient with acupuncture-induced infectious aortitis leading to aortic dissection. Chest computed-tomogram scan revealed Stanford type A dissection with pericardial effusion. Under the impression of an impending rupture, emergent surgery was performed. During surgery, infectious aortitis was identified incidentally, so she underwent resection of the infected aorta including surrounding tissues. Then the ascending aorta and hemi-arch were replaced with a prosthetic graft as an in situ fashion. The resected tissue and blood cultures revealed Staphylococcus aureus, so prolonged antibiotherapy was prescribed.