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Clinical and Experimental Rheumatology Apr 2023
Topics: Humans; Aortitis; Giant Cell Arteritis; Antibodies, Monoclonal, Humanized; Treatment Outcome; Recurrence
PubMed: 36995310
DOI: 10.55563/clinexprheumatol/ht170k -
Cureus Feb 2023Immunoglobulin G4-related disease (IgG4-RD) is an immunomediated disease that can virtually affect any organ. Despite the pancreas being known as the most frequently...
Immunoglobulin G4-related disease (IgG4-RD) is an immunomediated disease that can virtually affect any organ. Despite the pancreas being known as the most frequently involved organ, pulmonary and pleural IgG4-RD is being increasingly reported. The authors present two cases of IgG4-RD diagnosed in the same year, with different presentations and outcomes, in which the lung and pleural involvement were essential for the diagnosis. Recognizing IgG4-RD as a possible cause of chronic pleural effusion and/or thickening and lung abnormalities is important for an early diagnosis and prognosis improvement.
PubMed: 36994276
DOI: 10.7759/cureus.35439 -
Journal of Personalized Medicine Feb 2023Giant cell arteritis (GCA) and Takayasu arteritis (TA) are distinct types of large-vessel vasculitis; however, the clinical features of the diseases have some...
BACKGROUND
Giant cell arteritis (GCA) and Takayasu arteritis (TA) are distinct types of large-vessel vasculitis; however, the clinical features of the diseases have some similarities. Limited data are available regarding Japanese patients with GCA and TA. The present study aimed to compare the clinical features and outcomes of Japanese patients with GCA and TA and the effects of large vessel involvement (LVI).
METHODS
We performed a retrospective cohort study of the patients with GCA ( = 15) and TA ( = 30) who visited our department from April 2012 to June 2022. Signs and symptoms attributed to the disease, treatment, clinical outcomes, and mortality were recorded using a standardized database.
RESULTS
The median age of onset was significantly higher in the GCA group at 24 years (range, 16-72 years) in the TA group and 77 years (range, 57-89 years) in the GCA group ( < 0.001). There were no significant differences in survival rates or the cumulative rates of cardiovascular events between the GCA and TA groups. However, relapse-free survival rates were significantly higher in patients with GCA than in patients with TA. Seven of the 15 patients with GCA had large vessel involvement, which did not affect the survival rates. Prednisolone (PSL) doses were significantly decreased after induction therapy in both groups, and the rates of achieving steroid tapering (PSL < 5.0 mg/day) were significantly higher in patients with GCA compared with those in patients with TA.
CONCLUSIONS
Our study demonstrated no significant difference in the survival rates of Japanese patients with GCA and TA. The relapse-free survival rates were significantly higher in the GCA group than in the TA group. LVI may not be associated with disease relapse or survival rate in Japanese patients with GCA.
PubMed: 36983569
DOI: 10.3390/jpm13030387 -
JACC. Case Reports Mar 2023A 71-year-old male presented with 1-day history of back pain. Imaging displayed an enlarging thoracic aortic aneurysm with gas in the aortic wall. Blood cultures grew ....
A 71-year-old male presented with 1-day history of back pain. Imaging displayed an enlarging thoracic aortic aneurysm with gas in the aortic wall. Blood cultures grew . He underwent resection, debridement, and in situ aortic replacement with a rifampin-soaked graft under deep hypothermic circulatory arrest. His recovery was uncomplicated. ().
PubMed: 36974051
DOI: 10.1016/j.jaccas.2023.101783 -
Annals of Thoracic and Cardiovascular... Jan 2024A syphilitic aortitis is a late cardiovascular lesion of tertiary syphilis that has become exceptionally rare in the antibiotic era but not eradicated completely....
A syphilitic aortitis is a late cardiovascular lesion of tertiary syphilis that has become exceptionally rare in the antibiotic era but not eradicated completely. Syphilitic aortitis of ascending aorta complicates in ascending aortic aneurysm formation and aortic valve regurgitation, both requiring surgical treatment. After surgery, lifelong surveillance of the remainder of the aorta is recommended because of a priori supposed high incidence of delayed involvement of noninvolved aortic segments. A 3-year follow-up result of surgery of syphilitic ascending aortic aneurysm with aortic valve regurgitation in condition of active ongoing syphilitic aortitis and valvulitis is described with addressing the dimensions of remaining aortic segments. This case demonstrates that the dilatation of the remainder of the aorta does not occur during 3 years, at least when anti-syphilitic course of antibiotic is used just after operation without additional treatment during the follow-up period. A few reports on surgical treatment of syphilitic aneurysms of the ascending aorta are discussed.
Topics: Humans; Syphilis, Cardiovascular; Aortic Valve Insufficiency; Aneurysm, Ascending Aorta; Treatment Outcome; Aortic Aneurysm; Anti-Bacterial Agents; Aortic Valve
PubMed: 36967122
DOI: 10.5761/atcs.cr.22-00236 -
EJVES Vascular Forum 2023Intravesical Bacillus Calmette-Guerin (BCG) is an effective treatment for bladder carcinomas; however, extravesical BCG infection may occur in remote organs in patients...
INTRODUCTION
Intravesical Bacillus Calmette-Guerin (BCG) is an effective treatment for bladder carcinomas; however, extravesical BCG infection may occur in remote organs in patients with underlying primary immunodeficiency and is a potentially serious complication in 3-5% of cases. It includes granulomatous pneumonia, hepatitis as well as specific dermatological, ophthalmic, and haematopoietic manifestations. Diagnosis is difficult and often based on high clinical suspicion as in many cases is not isolated. This report presents a rare case of BCGaortitis treated in a tertiary care centre.
REPORT
A 74 year old man, with a history of bladder cancer treated with BCG therapy over a year ago, presented with malaise, abdominal pain, anorexia, and significant weight loss for several months associated with acute on chronic renal failure and a tender aneurysm. He was diagnosed with hepatic BCGitis and pararenal BCGaortitis. He was considered too high risk for open surgery after a multidisciplinary team meeting and was treated with a four vessel physician modified endograft (PMEG) and antituberculous therapy. At seven month follow up, he was clinically well and control computed tomography showed a patent endograft with complete exclusion of the aortic aneurysm.
DISCUSSION
Infectious BCG complications after intravesical BCG administration for bladder carcinomas can lead to severe early and late complications. In the present case, the patient presented with both liver and aortic BCG infection. The lack of positive microbiological data should not discourage clinicians from considering BCG infection even if several months have passed since the last BCG instillation.
PubMed: 36949865
DOI: 10.1016/j.ejvsvf.2023.02.003 -
Internal Medicine (Tokyo, Japan) Nov 2023
Topics: Humans; Aortitis; Granulocyte Colony-Stimulating Factor; Filgrastim
PubMed: 36948622
DOI: 10.2169/internalmedicine.1357-22 -
Internal Medicine (Tokyo, Japan) Nov 2023Aortitis is a rare adverse event associated with granulocyte colony-stimulating factor (G-CSF). Contrast-enhanced computed tomography (CECT) is widely used to diagnose...
Aortitis is a rare adverse event associated with granulocyte colony-stimulating factor (G-CSF). Contrast-enhanced computed tomography (CECT) is widely used to diagnose G-CSF-associated aortitis. However, the usefulness of gallium scintigraphy for the diagnosis of G-CSF-associated aortitis is unknown. We herein report a set of pre- and post-treatment gallium scintigrams of a patient with G-CSF-associated aortitis. During the diagnosis, gallium scintigraphy revealed hot spots on the arterial walls that appeared inflamed on CECT. Both the CECT and gallium scintigraphy findings disappeared. Gallium scintigraphy can be a supportive diagnostic tool for G-CSF-associated aortitis, especially in patients with an impaired renal function or allergy to iodine contrast.
Topics: Humans; Aortitis; Granulocyte Colony-Stimulating Factor; Radionuclide Imaging; Tomography, X-Ray Computed; Gallium
PubMed: 36948620
DOI: 10.2169/internalmedicine.1453-22 -
Methodist DeBakey Cardiovascular Journal 2023Management of aortic disease has evolved significantly over the past few decades. A preemptive diagnostic approach with a multidisciplinary team and shared... (Review)
Review
Management of aortic disease has evolved significantly over the past few decades. A preemptive diagnostic approach with a multidisciplinary team and shared decision-making has led to improved clinical outcomes. Surgery is the cornerstone of management for most aortic conditions; however, medical therapy is now an important adjunctive therapy in most if not all patients. Herein, we review the role and evidence behind medical management of patients with aortic disease.
Topics: Humans; Aortic Diseases
PubMed: 36910548
DOI: 10.14797/mdcvj.1192 -
Radiology. Cardiothoracic Imaging Feb 2023Supplemental material is available for this article.
Supplemental material is available for this article.
PubMed: 36860837
DOI: 10.1148/ryct.220192