Early recognition of aortitis of the aorta ascendens with 18F-FDG PET/CT: syphilitic?

We present the case of a 42-year-old woman known with a human leukocyte antigen B27 positive ankylosing spondylitis. Despite treatment with a tumor necrosis factor blocking agent, the patient was not pain free and inflammation markers remained elevated. An 18 F-fluorodeoxyglucose positron emission t...

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Bibliographic Details
Published in:Clinical rheumatology 2013-05, Vol.32 (5), p.705-709
Main Authors: Balink, H., Spoorenberg, A., Houtman, P. M., Brandenburg, A., Verberne, H. J.
Format: Article
Language:English
Subjects:
Adult
Aorta - pathology
Aortitis - diagnosis
Case Based Review
Diagnosis, Differential
Female
Fluorodeoxyglucose F18
HLA-B27 Antigen - biosynthesis
Humans
Inflammation
Medicine
Medicine & Public Health
Positron-Emission Tomography
Radiopharmaceuticals
Rheumatology
Spondylitis, Ankylosing - complications
Spondylitis, Ankylosing - metabolism
Syphilis, Cardiovascular - diagnosis
Tomography, X-Ray Computed
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Summary:We present the case of a 42-year-old woman known with a human leukocyte antigen B27 positive ankylosing spondylitis. Despite treatment with a tumor necrosis factor blocking agent, the patient was not pain free and inflammation markers remained elevated. An 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) was performed in an attempt to exclude possible other inflammatory processes. The 18 F-FDG PET/CT revealed increased metabolic activity in the ascending aortic wall, which appeared unexpectedly related to late syphilis. Based on this case and existing literature on this subject, we come to the conclusion that 18 F-FDG PET/CT can help in an early establishment of syphilitic aortitis before the possible life-threatening sequelae of syphilitic aortitis occur.
ISSN:0770-3198
1434-9949
DOI:10.1007/s10067-013-2178-6