| Aortitis and spondyloarthritis--an unusual presentation: case report and review of the literature. | |
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MedLine Citation:
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PMID: 19217648 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To report a patient with aortic regurgitation (AR) and aortitis, who failed to respond to multiple attempts at surgical replacement of the affected valve and adjacent aorta, and in whom a late diagnosis of spondyloarthritis (SpA) was made. The relevant literature on the association of SpA and aortitis is reviewed. METHODS: Descriptive case report of a patient with AR secondary to aortic dilation and aortitis with a late diagnosis of SpA, and a review of the relevant literature (PubMed search 1956 through April 2008). RESULTS: A 36-year-old man was admitted to the hospital for replacement of his aortic valve and aortic valve root as a result of AR after a dehiscence of a mechanical prosthetic valve and subsequent aortic pseudoaneurysm. His past medical history included 2 prior aortic valve replacements that failed due to late postoperative dehiscence. Histological findings from the aortic wall after the third operation showed signs of aortitis. A rheumatologic workup revealed a 6-year history of mild low back pain, radiological evidence of bilateral sacroiliitis, and presence of HLA-B27. A diagnosis of SpA, most likely ankylosing spondylitis (AS), was made. On reviewing the literature, AR has been diagnosed in 2 to 12% of the patients with AS, most of whom had long-lasting disease. There have been several reports of uncommon presentations of acute AR in young patients with juvenile AS; however, no similar adult case was found. CONCLUSION: This unusual case emphasizes the importance of early and adequate workup for SpA in young patients with lone AR or aortic dilation. |
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Authors:
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Lihi Eder; Mouhannad Sadek; Heather McDonald-Blumer; Dafna D Gladman |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-02-13 |
Journal Detail:
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Title: Seminars in arthritis and rheumatism Volume: 39 ISSN: 1532-866X ISO Abbreviation: Semin. Arthritis Rheum. Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306053 Medline TA: Semin Arthritis Rheum Country: United States |
Other Details:
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Languages: eng Pagination: 510-4 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Canada. benlihi@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aortic Valve Insufficiency / diagnosis*, etiology Aortitis / complications, diagnosis* HLA-B27 Antigen / blood Humans Male Spondylitis, Ankylosing / blood, complications, diagnosis* Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
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0/HLA-B27 Antigen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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