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Non-infectious aortitis often presents with non-specific symptoms leading to inappropriate diagnostic delay. We intend to describe the clinical spectrum and outcome of patients with aortitis diagnosed at a single centre.
We reviewed the clinical charts of patients diagnosed with non-infectious aortitis between January 2010 and December 2013 at the Rheumatology Division from a 1.000-bed tertiary teaching hospital from Northern Spain. The diagnosis of aortitis was usually based on FDG-PET-CT scan, and also occasionally on CT or MRI angiography or helical CT-scan.
During the period of assessment 32 patients (22 women and 10 men; mean age 68 years [range, 45-87]) were diagnosed with aortitis. The median interval from the onset of symptoms to the diagnosis was 21 months. FDG-PET CT scan was the most common tool used for the diagnosis of aortitis. The underlying conditions were the following: giant cell arteritis (n=13 cases); isolated polymyalgia rheumatica (PMR) (n=11); Sjögren's syndrome (n=2), Takayasu arteritis (n= 1); sarcoidosis (n=1), ulcerative colitis (n=1), psoriatic arthritis (n=1), and large-vessel vasculitis that also involved the aorta (n=2). The most common clinical manifestations at diagnosis were: PMR features, often with atypical clinical presentation (n=23 patients, 72%); diffuse lower limb pain (n=16 patients, 50%); constitutional symptoms (n=12 patients, 37%), inflammatory low back pain (n=9 patients, 28%) and fever (n=7 patients, 22%). Acute phase reactants were increased in most cases (median erythrocyte sedimentation rate 46 mm/1st hour, and a median serum C-reactive protein 1.5 mg/dL).
Aortitis is not an uncommon condition. The diagnosis is often delayed. Atypical PMR features, unexplained low back or limb pain, constitutional symptoms along with increased acute phase reactants should be considered 'red flags' to suspect the presence of aortitis.
Fuente: Clin Exp Rheumatol. 2015 Mar-Apr;33(2 Suppl 89):S-19-31
Editorial: Clinical and Experimental Rheumatology
Año de publicación: 2015
Nº de páginas: 12
Tipo de publicación: Artículo de Revista
RICARDO BLANCO ALONSO
JOSE LUIS HERNANDEZ HERNANDEZ
JOSE MANUEL CARRIL CARRIL
ISABEL MARTINEZ RODRIGUEZ
ANA MARIA CANGA VILLEGAS
ALONSO GUTIERREZ, JUAN
CALVO RÍO, VANESA
ORTÍZ SANJUÁN, FRANCISCO
PINA MURCIA, TRINITARIO
MARIA CARMEN GONZALEZ VELA
MARTÍNEZ AMADOR, NESTOR
MIGUEL ANGEL GONZALEZ-GAY MANTECON