Document Detail


Aortic aneurysm and orchitis due to Wegener's granulomatosis.
MedLine Citation:
PMID:  19748223     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present a patient with Wegener's granulomatosis (WG) with involvement of the abdominal aorta, testis, peripheral nerve system, and skin. A 51-year-old man presented at our outpatient clinic with lower back pain. He had a history of smoking, hypertension, and an embryonal carcinoma of the left testis, treated 13 years ago with orchidectomy and chemotherapy. One month earlier, he underwent a partial orchidectomy of the right testis due to testicular swelling. Abdominal computed tomography showed a 3.8 cm wide aneurysm of the distal part of the aorta with inflammation. One week later he was admitted to the hospital with numbness of his hands and feet. Physical examination showed signs of peripheral microemboli. Serological laboratory tests revealed elevated antineutrophil cytoplasmic antibody titers with positive reactions against proteinase-3, indicating Wegener's disease. The chest X-ray was normal. Pathological examination of the right testis showed necrotizing vasculitis of a small artery. He was treated with cyclophosphamide and prednisolone. WG with extrapulmonary involvement occurs infrequently, and reports of manifestations of WG in aorta, testis, the peripheral nerve system, and skin are even more uncommon. Small- and medium-vessel vasculitis can precede large-vessel vasculitis or occur in the absence of small-vessel involvement. Therefore, WG should be included in the work-up of large-vessel vasculitis, which can give rise to periaortic inflammation.
Authors:
R C Minnee; G E L van den Berk; J O Groeneveld; J van Dijk; K Turkcan; M J Visser; A C Vahl
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Publication Detail:
Type:  Case Reports; In Vitro; Journal Article     Date:  2009-09-11
Journal Detail:
Title:  Annals of vascular surgery     Volume:  23     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-10-30     Completed Date:  2010-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  786.e15-9     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Aneurysm, Abdominal / drug therapy,  etiology*,  radiography
Aortography / methods
Cyclophosphamide / administration & dosage
Drug Therapy, Combination
Female
Humans
Hypesthesia / etiology
Immunosuppressive Agents / administration & dosage
Male
Middle Aged
Orchitis / drug therapy,  etiology*,  pathology
Prednisolone / administration & dosage
Pulse Therapy, Drug
Testis / pathology
Tomography, X-Ray Computed
Treatment Outcome
Wegener Granulomatosis / complications,  diagnosis*,  drug therapy
Young Adult
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone

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