Today we had an excellent case of an elderly female presenting with abdominal pain radiating to the back, found to have peri-aortic inflammation / aortitis. She also had temporal / scalp tenderness and some non-specific visual symptoms concerning for vasculitis — in specific GCA…
Here are some teaching points from the conference;
With aortitis you should think about Infectious vs. Non-infectious causes
- Bacterial; Salmonella, Staphylococcus, Strep pneumo
- Syphilis (tree-barking)
- Mycobacterial (M tuberculosis)
Risk factors for infectious seeding of the aortic include prior pathology such as a plaque or aneurysm.
Non-infectious causes are more likely however, including:
Large vessel vasculitis; Takayasu (age <30), GCA / Temporal arteritis (age >50)
Variable vessel vasculitis; Behcet (recurrent oral ulcerations), and Cogan’s syndrome (young adults, chronic)
Other less likely autoimmune considerations include; relapsing polychondritis, SLE, HLA-B27 associated diseases, and ANCA associated diseases.