Document Detail

Aortitis and spondyloarthritis--an unusual presentation: case report and review of the literature.
MedLine Citation:
PMID:  19217648     Owner:  NLM     Status:  MEDLINE    
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.
Lihi Eder; Mouhannad Sadek; Heather McDonald-Blumer; Dafna D Gladman
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-02-13
Journal Detail:
Title:  Seminars in arthritis and rheumatism     Volume:  39     ISSN:  1532-866X     ISO Abbreviation:  Semin. Arthritis Rheum.     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-25     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1306053     Medline TA:  Semin Arthritis Rheum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  510-4     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, Toronto, Canada.
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MeSH Terms
Aortic Valve Insufficiency / diagnosis*,  etiology
Aortitis / complications,  diagnosis*
HLA-B27 Antigen / blood
Spondylitis, Ankylosing / blood,  complications,  diagnosis*
Tomography, X-Ray Computed
Reg. No./Substance:
0/HLA-B27 Antigen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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