Aortitis: Difference between revisions
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== Clinical Manifestations == |
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* Varied, depending on location and cause |
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* Classically, back or abdominal pain with fever |
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* May cause [[aortic regurgitation]] and [[acute aortic syndrome]] |
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== Differential Diagnosis == |
== Differential Diagnosis == |
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* Inflammatory disorders |
* Inflammatory disorders |
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** [[Large-vessel vasculitis]]: [[giant cell arteritis]], [[Takayasu arteritis]], [[rheumatoid arthritis]], [[systemic lupus erythematosus]], [[ankylosing spondylitis]], [[Reiter syndrome]] |
** [[Large-vessel vasculitis]]: [[giant cell arteritis|'''giant cell arteritis''']], [[Takayasu arteritis|'''Takayasu arteritis''']], [[rheumatoid arthritis]], [[systemic lupus erythematosus]], [[ankylosing spondylitis]], [[Reiter syndrome]] |
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** Other [[Vasculitis|vasculitides]]: [[ANCA-associated vasculitis]] ([[granulomatosis with polyangiitis]], [[polyarteritis nodosum]], [[microscopic polyangiitis]]), [[Behçet disease]], [[Cogan syndrome]], [[relapsing polychondritis]] |
** Other [[Vasculitis|vasculitides]]: [[ANCA-associated vasculitis]] ([[granulomatosis with polyangiitis]], [[polyarteritis nodosum]], [[microscopic polyangiitis]]), [[Behçet disease]], [[Cogan syndrome]], [[relapsing polychondritis]] |
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** [[Sarcoidosis]] |
** [[Sarcoidosis]] |
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** Bacterial: [[Salmonella]], [[Staphylococcus]], [[Streptococcus pneumoniae]], others |
** Bacterial: [[Salmonella]], [[Staphylococcus]], [[Streptococcus pneumoniae]], others |
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** [[Syphilis]] |
** [[Syphilis]] |
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** [[ |
** [[Tuberculous aortitis]] |
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* Drug-induced: chemotherapy (taxanes and platinum-based), [[GCSF]] (particularly when conjugated with PEG) |
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== Investigations == |
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* CTA or MRA to noninvasively confirm the diagnosis |
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* Duplex ultrasound of temporal arteries, looking for halo sign to suggest [[GCA]] |
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* CBC, creatinine, liver panel, ESR/CRP |
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* Blood cultures, for bacterial cause |
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* Syphilis serology |
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* Tuberculin skin test |
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* Rheumatology panel: ANA, ANCA, RF |
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== Further Reading == |
== Further Reading == |
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Latest revision as of 21:24, 12 March 2023
Clinical Manifestations
- Varied, depending on location and cause
- Classically, back or abdominal pain with fever
- May cause aortic regurgitation and acute aortic syndrome
Differential Diagnosis
- Inflammatory disorders
- Large-vessel vasculitis: giant cell arteritis, Takayasu arteritis, rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, Reiter syndrome
- Other vasculitides: ANCA-associated vasculitis (granulomatosis with polyangiitis, polyarteritis nodosum, microscopic polyangiitis), Behçet disease, Cogan syndrome, relapsing polychondritis
- Sarcoidosis
- Isolated aortitis
- Infections
- Bacterial: Salmonella, Staphylococcus, Streptococcus pneumoniae, others
- Syphilis
- Tuberculous aortitis
- Drug-induced: chemotherapy (taxanes and platinum-based), GCSF (particularly when conjugated with PEG)
Investigations
- CTA or MRA to noninvasively confirm the diagnosis
- Duplex ultrasound of temporal arteries, looking for halo sign to suggest GCA
- CBC, creatinine, liver panel, ESR/CRP
- Blood cultures, for bacterial cause
- Syphilis serology
- Tuberculin skin test
- Rheumatology panel: ANA, ANCA, RF
Further Reading
- Aortitis. Circulation. 2008;117(23):3039–51. doi: 10.1161/CIRCULATIONAHA.107.760686
