Live from 6RC! 12.27.19

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

Infectious includes:  

  • 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.

 

SA

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