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Aortic Disease
Published in Paul Schoenhagen, Frank Dong, Cardiac CT Made Easy, 2023
Morphologic changes associated with aortitis can be assessed with CT. Typical findings in the acute setting are wall thickening (Figure 10.53) and branch vessel stenosis. In chronic stages, branch vessel stenosis and extensive calcification are seen. The role of positron emission tomography (PET)/CT in the assessment of disease activity is incompletely understood (Figure 10.54). Isolated aortitis describes a clinical scenario where histologic evidence of aortitis is identified in surgical samples after aortic surgery, but no clinical symptoms of vasculitis are present. In these patients, diffuse aortic dilatation has been described.159,160
Diseases of the Aorta
Published in Mary N. Sheppard, Practical Cardiovascular Pathology, 2022
All histopathological classification of aortitis shows the largest group to be giant cell aortitis. Studies of large aortic surgical series have reported the rate to be between 2% and 5% of all aortic pathology.3,12 Takayasu arteritis (TA) and giant cell arteritis (GCA) represent the two major categories. There is considerable overlap of histological findings between the noninfective types and chronic infective types such as syphilis, tuberculosis, human immunodeficiency disease and rickettsia aetiologies.
Aortic disease
Published in Paul Schoenhagen, Carl J. Schultz, Sandra S. Halliburton, Cardiac CT Made Easy, 2014
Paul Schoenhagen, Carl J. Schultz, Sandra S. Halliburton
Morphologic changes associated with aortitis in the context of connective tissue diseases can be assessed with CT.385 Typical findings are wall thickening and extensive calcification in later stages (Figure 10.73a and 10.73b). The potential role of positron emission tomography (PET)/CT scanners for the assessment of disease activity is currently being evaluated (Figure 10.74); however, it is not an approved or reimbursed application.386
The feasible maintenance dose of corticosteroid in Takayasu arteritis in the era of biologic therapy
Published in Scandinavian Journal of Rheumatology, 2021
T Shirai, H Sato, H Fujii, T Ishii, H Harigae
The differences in the response to treatment suggest the heterogeneous nature of TAK, although the presentation is commonly aortitis. The causes of aortitis include primary LVV infection and drugs, including TNF inhibitors and granulocyte colony-stimulating factor (23). In particular, the association of TAK with human leucocyte antigen (HLA)-B52, HLA-B67, and interleukin-12B has been reported (24). As effector cells, immune cells, including macrophages, T cells, and B cells, also play critical roles (25, 26). In 2020, we identified novel autoantibodies, anti-EPCR antibody, and anti-SRBI antibody in TAK; thus, TAK seems to be constituted by several subgroups (27). Therefore, it is important to investigate the response to treatments from the viewpoint of these different subgroups of TAK in the future.
Myocarditis and carotidynia caused by Granulocyte-Colony stimulating factor administration
Published in Modern Rheumatology Case Reports, 2020
Elena Corral de la Fuente, Arantza Barquín Garcia, Cristina Saavedra Serrano, Juan José Serrano Domingo, Roberto Martín Huertas, María Fernández Abad, Noelia Martínez Jáñez
Acute aortitis and arteritis after G-CSF administration are described as rare side effects in pegfilgrastrim and filgrastim data sheets [1]. Up to date, few cases of aortitis secondary to G-CSF have been published [16], three of them with pegfilgrastrim [8,13,14] and eight with filgrastim [5–7,9–12]. Aortitis presented rapidly (2–11 days) after G-CSF administration. All these patients experienced non-specific symptoms such as fever, abdominal pain, back pain and elevation of inflammatory markers (Table 1). The diagnosis was carried out by CT scan in the majority of cases and this might also indicate that aortitis could be an underdiagnosed adverse event of G-CSF treatment. Most patients achieved resolution of aortitis after steroid treatment, although two cases of aortitis were resolved spontaneously without treatment [12,14].
Mucormycosis with peculiar aortic involvement in a child with acute lymphoblastic leukemia
Published in Pediatric Hematology and Oncology, 2020
Giada Biddeci, Michele Antonello, Marco Pizzi, Maria Grazia Petris, Marta Pillon, Daniele Donà, Alessandra Biffi, Maria Caterina Putti
Molacek et al described 17 cases of abdominal aortic infection in adult age, caused by bacteria and Candida albicans.10 Aorta is usually resistant against infections, but aortic pathologies (atherosclerosis, ulceration) or immunocompromised status could predispose to aortitis. The clinical manifestations of aortitis are often nonspecific: fever, thoracic or abdominal pain, chills, depending upon the site of aneurysm formation. Our patient presented fever, severe abdominal and back pain and worsened to anuria before surgery. The gold standard therapy of infectious arteritis is the combination of antibiotic or antimycotic therapy, with complete surgical excision of infected vessel. The intent of surgery is to confirm the diagnosis, surgical debridement and prosthetic reconstruction of the arterial wall. In our child, prompt surgery helped to achieve better disease control. Aggressive antifungal therapy, while controlled the infection in the lung, was not able to prevent vascular dissemination and vessel destruction.