Document Detail


Fever due to aortitis.
MedLine Citation:
PMID:  16369888     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case of vasculitis with predominant aortic involvement. Vasculitis of large vessels has a limited number of tools for diagnosis and follow-up. A 78-year-old woman was referred to the internal medicine department with a 2-month history of fever of unknown origin (FUO), night sweats, weight loss and markedly elevated ESR and CRP. The results of an extended routine investigation found no infection, malignancy, hypersensitivity or autoimmune disorder. The patient did not suffer from claudication; systolic blood pressure difference between arms was 20 mm Hg. Temporal artery biopsies were negative. 2-18F-Fluorine-2-deoxy-D -glucose positron emission tomography (FDG PET) scan imaging demonstrated intense FDG uptake along the aorta and in the brachio-cephalic and carotid arteries consistent with arteritis. A high dose of corticosteroid therapy (1 mg/kg) was instituted with further tapering. The therapy was followed by complete resolution of the symptoms and pathological FDG uptake on repeated FDG PET. Second-line therapy was not added because of positive conversion of Mantaux test followed by rifampicin prophylaxis. FDG PET should be a part of the work-up of FUO when routine investigation fails to determine its etiology. FDG PET is useful both for diagnosis and assessment of response to therapy for large-vessel vasculitis.
Authors:
Alexander P Rozin; Rachel Bar-Shalom; Alexander Strizevsky; Giris Jacob
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2005-12-21
Journal Detail:
Title:  Clinical rheumatology     Volume:  26     ISSN:  0770-3198     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2006-12-22     Completed Date:  2007-03-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  265-7     Citation Subset:  IM    
Affiliation:
B. Shine Department of Rheumatology, Rambam Medical Center and Rappaport Faculty of Medicine, Israel-Technion Institute of Technology, P.O. Box 9602, Haifa, 31096, Israel. a_rozin@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta / pathology*,  radionuclide imaging
Aortitis / complications*,  drug therapy,  radionuclide imaging
Brachiocephalic Trunk / pathology,  radionuclide imaging
Carotid Arteries / pathology,  radionuclide imaging
Female
Fever of Unknown Origin / drug therapy,  etiology*,  pathology
Fluorodeoxyglucose F18 / diagnostic use
Glucocorticoids / therapeutic use
Humans
Positron-Emission Tomography
Prednisone / therapeutic use
Radiopharmaceuticals / diagnostic use
Treatment Outcome
Chemical
Reg. No./Substance:
0/Glucocorticoids; 0/Radiopharmaceuticals; 53-03-2/Prednisone; 63503-12-8/Fluorodeoxyglucose F18

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


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