Autoimmune aspects of chronic periaortitis

Vaglio, Augusto; Greco, Paolo; Corradi, Domenico; Palmisano, Alessandra; Martorana, Davide; Ronda, Nicoletta; Buzio, Carlo

doi:10.1016/j.autrev.2006.03.011

Cited by 99 publications

(86 citation statements)

References 33 publications

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“…Therefore, surgical treatment appears prudent once the diameter of the aneurysm exceeds 5.5 cm. In some cases, the inflammatory process may persist or even progress despite surgery [2] .Diagnosis of persistent CP following surgical aneurysm exclusion was also taken in our case, as PET scan showed persistence of metabolic activity in ascending aorta. Due to chronic and relapsing nature, long-term follow-up is recommended in all patients.…”

Section: Galicia Clínica | Sociedade Galega De Medicina Internamentioning

confidence: 94%

“…There is rarely extent of fibrosis to the duodenum, bile ducts, pancreas, colon, epidural space, with very different clinical presentations. The positivity of anti-neutrophil cytoplasmic antibodies, rheumatoid factor and antibodies against smooth muscle cells and thyroglobulin, detected in some patients, may indicate an associated auto-immune disorder [1,2,5,6] . Definitive diagnostic tests include contrast-enhanced CT scan and magnetic resonance imaging (MRI).…”

Section: Galicia Clínica | Sociedade Galega De Medicina Internamentioning

confidence: 99%

“…Treatment decisions related to the degree of dose reduction must be individualized and based on clinical and radiological response. Other drugs with different mechanism of action, such as tamoxifen, have recently been used as adjuvant in steroids treatment with apparent success [1][2][3]15] . In the early stages of disease, when the inflammatory component is more important than the fibrotic component, placement of ureteral stent or nephrostomy followed by medical treatment is recommended, without recourse to surgery [2,15] .…”

Section: Galicia Clínica | Sociedade Galega De Medicina Internamentioning

confidence: 99%

“…In IAAs and PRF the fibroinflammatory tissue develops around a dilated aorta, and consequently are referred to as aneurysmal forms of CP. IRF corresponds to the non-aneurysmal form [1][2][3][4] . Current theories suggest two potential pathogenetic mechanisms of CP.…”

Section: Introductionmentioning

confidence: 99%

“…Chronic periaortitis (CP) is a rare idiopathic disease, characterized by a thickening of the aortic wall which may vary from an inflammatory infiltrate in the acute phase until a fibrous scar in more advanced stages and usually manifests by symptoms resulting from compression of surrounding structures, especially, urinary tract and vascular structures [1][2][3] .CP encompasses three main entities namely: idiopathic retroperitoneal fibrosis (IRF); inflammatory aortic aneurysms (IAAs) and perianeurysmal retroperitoneal fibrosis (PRF). In IAAs and PRF the fibroinflammatory tissue develops around a dilated aorta, and consequently are referred to as aneurysmal forms of CP.…”

Section: Introductionmentioning

confidence: 99%

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Chronic periaortitis and antiphospholipid syndrome: is there a link?

Carneiro¹,

Ferreira²,

Rios³

2016

Gal. Clin.

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A 64-year-old man was referred to internal medicine consultation with a 6-month history of anorexia, weight loss (22 % of body weight) and progressive pain in the abdomen radiating to the lower back. He had a past strong medical history of cardiovascular disease with systemic hypertension, coronary disease and open surgical repair of a ruptured ascending thoracic aortic aneurysm 4 years before. Relevant medical background also included two episodes of deep venous thrombosis (DVT) in the last year. On physical examination there was an abdominal pulsatile mass. Initial laboratory findings showed microcytic anemia (8.9 g/dL; N 12-13 g/dL), elevated erythrocyte sedimentation rate (133mm 1st hour; N<20mm 1st hour) and C-reactive protein (13 mg/dL; N<5 mg/L), and renal dysfunction (creatinine 2.8 mg/dL; N<1 mg/dL) without proteinuria or red blood cells casts. The serum proteinogram showed polyclonal hypergammaglobulinemia with raised level of IgG (1945 mg/dl) but normal serum IgG4 concentrations. Serological testing for EBV, CMV, HSV, parvovirus B19, HIV, hepatitis B and C, syphilis and tuberculosis skin testing were negative. Immunological studies revealed persistent high levels of IgM anticardiolipin (aCL) antibody (159.5 MPL, positive >11) and IgM β2-glycoprotein (B2G) antibody (168 U/mL, positive >11), with negative lupus anticoagulant, measured on two occasions 4 months apart. Workup for other autoimmune disorders was unremarkable, including negative anti-neutrophil cytoplasmic antibodies and antinuclear antibody panel. A thoracoabdominal computed tomography (CT) scan was made and showed an aneurysm of the infrarenal abdominal aorta with 4.1 cm in diameter and bilateral hydronephrosis ( figure 1 -C). In addition, there was a 'sleeve' of abnormal material of soft tissue density surrounding the right brachiocephalic trunk, aortic arch, descending aorta, abdominal aorta and common iliac arteries (Figure 1 -A and 1-B AbstractChronic periaortitis (CP) is a rare fibro-inflammatory disease characterized by periaortic fibrosis and/or aortic aneurysms formation, mostly localized in retroperitoneum and occasionally in the mediastinum. Recent studies have shown its common association with autoimmune diseases, therefore autoimmunity has been proposed as a contributing factor. Herein, we describe the second case in the literature of CP associated with antiphospholipid syndrome. A 64-year-old man with history of open surgery for inflammatory thoracic aortic aneurysm and recurrent deep vein thrombosis was referred for abdominal pain and weight loss in the last 6 months. Further investigation revealed elevated acute-phase reactant levels, positive antiphospholipid autoantibodies, radiological and histological evidence of periaortic fibrosis and inflammation causing abdominal aortic aneurysm and ureteral obstruction. Diagnosis of CP and antiphospholipid syndrome were made and steroid therapy was implemented with clinical and radiological improvement. The present report further supports the potentially immune-mediated origin of ...

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Section: Galicia Clínica | Sociedade Galega De Medicina Internamentioning

confidence: 94%

Section: Galicia Clínica | Sociedade Galega De Medicina Internamentioning

confidence: 99%

Section: Galicia Clínica | Sociedade Galega De Medicina Internamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Chronic periaortitis and antiphospholipid syndrome: is there a link?

Carneiro¹,

Ferreira²,

Rios³

2016

Gal. Clin.

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The incidence rate and histological characteristics of intimal hyperplasia in elastase‐induced experimental abdominal aortic aneurysms in mice

Li,

Wei,

et al. 2023

Anim Models and Exp Med

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Intimal hyperplasia (IH) is a negative vascular remodeling after arterial injury. IH occasionally occurs in elastase‐induced abdominal aortic aneurysm (AAA) mouse models. This study aims to clarify the incidence and histological characteristics of IH in aneurysmal mice. A retrospective study was conducted by including 42 male elastase‐induced mouse AAA models. The IH incidence, aortic diameters with or without IH, and hyperplasia lesional features of mice were analyzed. Among 42 elastase‐induced AAA mouse models, 10 mice developed mild IH (24%) and severe IH was found in only 2 mice (5%). The outer diameters of the AAA segments in mice with and without IH did not show significant difference. Both mild and severe IH lesions show strong smooth muscle cell positive staining, but endothelial cells were occasionally observed in severe IH lesions. There was obvious macrophage infiltration in the IH lesions of the AAA mouse models, especially in mice with severe IH. However, only a lower numbers of T cells and B cells were found in the IH lesion. Local cell‐secreted matrix metalloproteinases (MMP) 2 was highly expressed in all IH lesions, but MMP9 was only overexpressed in severe lesions. In conclusion, this study is the first to demonstrate the occurrence of aneurysmal IH and its histological characteristics in an elastase‐induced mouse AAA model. This will help researchers better understand this model, and optimize it for use in AAA‐related research.

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Do acute‐phase reactants predict response to glucocorticoid therapy in retroperitoneal fibrosis?

Magrey

Husni

Kushner

et al. 2009

Arthritis & Rheumatism

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Objective. To determine the value of the erythrocyte sedimentation rate (ESR) and the C-reactive protein (CRP) level at the time of diagnosis for predicting radiographic response to glucocorticoid therapy in patients with retroperitoneal fibrosis (RFP). Methods. Data were collected retrospectively for 37 patients with an established diagnosis of RFP (the diagnosis was proven by biopsy in 31 patients), all of whom met the following inclusion criteria: 1) availability of a recorded baseline ESR and/or CRP level and results of computed tomography or magnetic resonance imaging, 2) availability of followup CRP level and/or ESR with radiographic imaging 12-24 weeks after initiation of therapy, and 3) treatment with prednisone monotherapy at a starting dosage of 40 -60 mg daily. Patients were divided into 2 therapeutic response groups: group 1 showed radiographic regression, and group 2 showed no change or radiographic progression. Any progression or regression was determined by an estimated change of >25%.

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Autoimmune aspects of chronic periaortitis

Cited by 99 publications

References 33 publications

Chronic periaortitis and antiphospholipid syndrome: is there a link?

Chronic periaortitis and antiphospholipid syndrome: is there a link?

The incidence rate and histological characteristics of intimal hyperplasia in elastase‐induced experimental abdominal aortic aneurysms in mice

Do acute‐phase reactants predict response to glucocorticoid therapy in retroperitoneal fibrosis?

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