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      Aortitis requiring aortic repair associated with glaucoma, thyroiditis, glaucoma, and neuropathy: case report

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          Abstract

          Aortitis may be due to infectious and non-infectious causes. We observed aortitis, associated with glaucoma, thyroiditis, pericarditis, pleural effusion and neuropathy in a 63-years old woman. Despite antibiotic therapy, inflammatory signs persisted and resolved only after initiation of glucocorticoid therapy. Increasing aortic ectasia necessitated resection of the ascending aorta and implantation of a Vascutek 30 mm prosthesis. Histologically a granulomatous aortitis was diagnosed. Since all other possible causes were excluded, an immunological mechanism of the aortitis is suspected and possible triggering factors are discussed.

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          Aortitis.

          Mark Creager, Heather L. Gornik (2008)
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            Practice guidelines for the treatment of Lyme disease. The Infectious Diseases Society of America.

            Katherine A Steere, B Luft, R Dattwyler … (2000)
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              Surgical pathology of the ascending aorta: a clinicopathologic study of 513 cases.

              Thomas W D Edwards, A Kral, Vernon S Pankratz … (2006)
              Only 2 comprehensive surgical series, published in 1977 and 1983, have evaluated clinicopathologic features of the ascending aorta. Retrospective review of medical records and microscopic slides was performed on 513 consecutive patients with surgical resection of ascending aortic tissue (1985 to 1999). Patients were 2 to 89 years old (mean 59 y), and 303 (59%) were men. Aneurysm or dissection was the indication for surgery in 479. Aortic valves were also excised in 360. Systemic hypertension was present in 279, inherited connective tissue disease (ICTD) in 67, arteritis in 33, and acquired connective tissue disease in 16. Microscopy showed cystic medial degeneration (CMD) in 209, aortic dissection (AD) in 109 (with CMD in 56), normal media in 90, aortitis in 57 (with CMD in 14), and other findings in 48. The most significant, independent risk factor of CMD and AD was ICTD (confidence interval=7.61 and 2.26, respectively). Systemic hypertension was more common in patients with AD than without (P=0.0202). Normal media was the most common histologic finding associated with bicuspid aortic valve (P<0.0001). Among 57 patients with aortitis (giant cell in 39), ages ranged from 16 to 85 years (mean 64 y), and 42 (74%) were women; only 8 had Takayasu arteritis, and 11 had temporal or systemic arteritis. In surgically resected ascending aorta, the 3 most common histologic findings were CMD, AD, and normal media. ICTD, systemic hypertension, and bicuspid aortic valve were common comorbid findings. Giant cell aortitis occured predominantly in women, usually without systemic disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Cardiothorac Surg
                Title: Journal of Cardiothoracic Surgery
                Publisher: BioMed Central
                ISSN (Electronic): 1749-8090
                Publication date Collection: 2011
                Publication date (Electronic): 16 May 2011
                Volume: 6
                Page: 74
                Affiliations
                [1 ]2nd Medical department, Krankenanstalt Rudolfstiftung, Juchgasse 25, Wien, A-1030, Österreich, Austria
                [2 ]Department of Gynecology and Obstetrics, Krankenanstalt Rudolfstiftung, Juchgasse 25, Wien, A-1030, Österreich, Austria
                [3 ]Department of Cardiac Surgery, Allgemeines Krankenhaus, Währingerstraße 18-20, 1090 Wien, Österreich, Austria
                [4 ]Institute of Pathology, Allgemeines Krankenhaus, Währingerstraße 18-20, Wien, A-1030, Österreich, Austria
                [5 ]Department of Radiology, Krankenanstalt Rudolfstiftung, Juchgasse 25, Wien, A-1030, Österreich, Austria
                [6 ]Department of Neurology, Krankenanstalt Rudolfstiftung, Juchgasse 25, Wien, A-1030, Österreich, Austria
                Article
                Publisher ID: 1749-8090-6-74
                DOI: 10.1186/1749-8090-6-74
                PMC ID: 3113932
                PubMed ID: 21575249
                SO-VID: 6db2b244-f233-4fec-bbee-2c71e48eeb2f
                Copyright © Copyright ©2011 Stöllberger et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 October 2010
                Date accepted : 16 May 2011
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Surgery
                Data availability:
                ScienceOpen disciplines: Surgery

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