Fever due to aortitis
Fever due to aortitis
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主动脉炎引起的发烧
DOI：
10.1007/s10067-005-0134-9
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发表时间：
2006
影响因子：
3.4
通讯作者：
G. Jacob
中科院分区：
文献类型：
--
作者：
A. Rozin;R. Bar;A. Strizevsky;G. Jacob
我们报告一例血管炎，主要累及主动脉。大血管炎的诊断和随访工具有限。一名78岁女性因不明原因发热（FUO）、盗汗、体重减轻、ESR和CRP明显升高而被转介到内科。延长常规检查的结果未发现感染、恶性肿瘤、过敏或自身免疫性疾病。患者没有跛行；两臂收缩压差为20 mm Hg，颞动脉活检呈阴性。2- 18f -氟-2-脱氧-d-葡萄糖正电子发射断层扫描（FDG PET）成像显示沿主动脉、头臂动脉和颈动脉有强烈的FDG摄取，与动脉炎一致。采用高剂量皮质类固醇治疗（1mg /kg）并进一步减量。治疗后症状完全消失，FDG PET重复检测病理FDG摄取。由于Mantaux试验转化阳性，随后利福平预防治疗，未添加二线治疗。当常规检查不能确定其病因时，FDG PET应作为FUO检查的一部分。FDG PET对大血管炎的诊断和治疗反应评估都是有用的。
We report a case of vasculitis with predominant aortic involvement. Vasculitis of large vessels has a limited number of tools for diagnosis and follow-up. A 78-year-old woman was referred to the internal medicine department with a 2-month history of fever of unknown origin (FUO), night sweats, weight loss and markedly elevated ESR and CRP. The results of an extended routine investigation found no infection, malignancy, hypersensitivity or autoimmune disorder. The patient did not suffer from claudication; systolic blood pressure difference between arms was 20 mm Hg. Temporal artery biopsies were negative. 2-18F-Fluorine-2-deoxy-d-glucose positron emission tomography (FDG PET) scan imaging demonstrated intense FDG uptake along the aorta and in the brachio–cephalic and carotid arteries consistent with arteritis. A high dose of corticosteroid therapy (1 mg/kg) was instituted with further tapering. The therapy was followed by complete resolution of the symptoms and pathological FDG uptake on repeated FDG PET. Second-line therapy was not added because of positive conversion of Mantaux test followed by rifampicin prophylaxis. FDG PET should be a part of the work-up of FUO when routine investigation fails to determine its etiology. FDG PET is useful both for diagnosis and assessment of response to therapy for large-vessel vasculitis.