Document Detail


Panaortitis: diagnosis via fluorodeoxyglucose positron emission tomography.
MedLine Citation:
PMID:  16284486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 57-year-old woman was admitted with a 2-month history of low-grade fever, malaise, and weight loss. Physical examination findings were unremarkable except for a systolic murmur of a known mild aortic regurgitation. Laboratory tests revealed only mild leukocytosis and an elevated sedimentation rate. Serology tests for viral and bacterial pathogens, blood and urine cultures, and immunology tests had negative results. Total body computed tomography, transesophageal echocardiography, and biopsies of bone, liver, and temporal arteries were normal. Wide-spectrum antibiotics effected no change in the patient's illness. Low-dose steroids given for a suspected polymyalgia rheumatica caused only minimal and transient improvement. Re-evaluation showed no new findings. Fluorodeoxyglucose positron emission tomography (FDG-PET) was done and showed an abnormally increased uptake along the aortic arch, the descending aorta, and bilaterally in the subclavian and carotid arteries, compatible with arteritis. High-dose steroids and later methotrexate were given and caused obvious improvement, with complete resolution of symptoms. We conclude that FDG-PET should be a part of the usual work-up of fever of unknown origin, especially in cases in which routine investigation reveals no cause.
Authors:
Ronen Zalts; Shadi Hamoud; Rachel Bar-Shalom; Oron Eilam; Alexander Rozin; Tony Hayek
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  330     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-14     Completed Date:  2005-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  247-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine E, Rambam Medical Center and the Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel. r_zalts@rambam.health.gov.il
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MeSH Terms
Descriptor/Qualifier:
Aortitis / drug therapy,  radionuclide imaging*
Drug Therapy, Combination
Female
Fluorodeoxyglucose F18 / diagnostic use*
Humans
Methotrexate / administration & dosage,  therapeutic use
Middle Aged
Positron-Emission Tomography*
Prednisone / administration & dosage,  therapeutic use
Radiopharmaceuticals / diagnostic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 53-03-2/Prednisone; 59-05-2/Methotrexate; 63503-12-8/Fluorodeoxyglucose F18

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


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