Evidence of autoimmunity in chronic periaortitis: a prospective study

Vaglio, Augusto; Corradi, Domenico; Manenti, Lucio; Ferretti, Stefania; Garini, G; Buzio, Carlo

doi:10.1016/s0002-9343(03)00056-1

Cited by 191 publications

(190 citation statements)

References 22 publications

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“…A recent case-control study that compared inflammatory and noninflammatory abdominal aortic aneurysms showed that IAAAs are more (6). Likewise, in a recent study, we found that in 7 (44%) of 16 cases CP was associated with other autoimmune conditions, namely ANCA-positive renal disease and autoimmune tyroiditis (7). Finally, various case reports have described an association between CP and numerous autoimmune diseases including well-defined small-and medium-vessel vasculitis (Wegener's granulomatosis, polyarteritis nodosa, Henoch-Schoenlein purpura) (9 -11), unclassifiable "systemic vasculitis" (8,12), aortitis (13), or different types of immune-mediated glomerulonephritis (membranous, membrano-proliferative, and rapidly progressive glomerulonephritis) (18,19).…”

Section: Discussionsupporting

confidence: 61%

“…Finally, various case reports have described an association between CP and numerous autoimmune diseases including well-defined small-and medium-vessel vasculitis (Wegener's granulomatosis, polyarteritis nodosa, Henoch-Schoenlein purpura) (9 -11), unclassifiable "systemic vasculitis" (8,12), aortitis (13), or different types of immune-mediated glomerulonephritis (membranous, membrano-proliferative, and rapidly progressive glomerulonephritis) (18,19). Ankylosing spondylitis, a condition sometimes linked to ascending aortitis, has also been reported to be associated with CP (12,20,21), whereas the association with rheumatoid arthritis and systemic lupus erythematosus is uncommon (7,22). Finally, CP (particularly IRF) may frequently be associated with fibroinflammatory disorders affecting other organs (sclerosing cholangitis, mediastinal fibrosis, Riedel's and chronic autoimmune thyroiditis) (3,8,23), most of which are thought to have an autoimmune pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…None had any clinical or laboratory evidence of chronic infections or tumors, none had undergone previous abdominal surgery, and none were taking any medications known to induce the development of CP. All the patients received a standardized laboratory evaluation, as previously described (7). PET imaging was performed at diagnosis before therapy was started.…”

Section: Subjectsmentioning

confidence: 99%

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Positron emission tomography (PET): Evaluation of chronic periaortitis

Salvarani¹,

Pipitone²,

Versari³

et al. 2005

Arthritis & Rheumatism

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131

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Objective. To evaluate the presence and extent of large-vessel inflammation in patients with chronic periaortitis (CP) using 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET). Methods. A consecutive case series consisting of 7 patients with CP seen over a 3-year period and a control group of 14 patients with malignancy were evaluated with FDG-PET. For every case we selected 2 age-and sex-matched controls who underwent PET imaging for malignancy. The diagnosis of CP was made by means of computed tomography. PET imaging was performed at diagnosis before therapy was started. Measurement of vascular uptake was graded using a 4-point semiquantitative scale. Results. All patients had evidence of grade 2؉ or 3؉ vascular uptake in the abdominal aorta and/or iliac artery. No controls showed vascular uptake greater than 1؉. Vascular uptake in the thoracic aorta and/or in its branches was seen in 3 (43%) of 7 patients. Vascular uptake in abdominal aorta and/or iliac artery was observed in patients with CP but not in controls (100% versus 0%). There was also a significantly more frequent FDG uptake in the large thoracic arteries in case-patients compared with controls (43% versus 0%; P ‫؍‬ 0.03). Conclusion. FDG-PET scan shows in patients with CP the presence of a large-vessel vasculitis involving abdominal aorta and common iliac arteries, which in some patients is also extended to thoracic aorta and/or its branches.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

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Positron emission tomography (PET): Evaluation of chronic periaortitis

Salvarani¹,

Pipitone²,

Versari³

et al. 2005

Arthritis & Rheumatism

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131

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“…Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level are frequently high, and in some cases patients are positive for autoantibodies (4). The diagnosis is made by means of computed tomography (CT) or magnetic resonance imaging (MRI), but a histologic examination of the retroperitoneal tissue is sometimes required.…”

Section: Introductionmentioning

confidence: 99%

¹⁸F‐fluorodeoxyglucose positron emission tomography in the diagnosis and followup of idiopathic retroperitoneal fibrosis

Vaglio¹,

Versari²,

Fraternali³

et al. 2005

Arthritis & Rheumatism

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“…Our patient demonstrated evidence of 2.3-cm abdominal aortic dilatation without a history of hypertension just over 1.5 years prior to presenting with associated RPF. Studies suggest that chronic periaortitis results from a local inflammatory reaction to antigens in the atherosclerotic plaques of the abdominal aorta (3,(21)(22)(23)(24)(25)(26). However, the presence of constitutional symptoms, high concentrations of acute-phase reactants, and frequent association with autoimmune diseases that involve other organs would seem to indicate that chronic periaortitis (including IRPF) may be a manifestation of a systemic autoimmune or inflammatory disease (3,22,23,27).…”

Section: Irpfmentioning

confidence: 99%

A 45‐year‐old man with flank pain and inability to ejaculate

Muskardin

Gertner

2012

Arthritis Care & Research

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A 45-year-old man with left-sided flank pain and difficulty ejaculating. History of the Present IllnessThe patient developed left-sided flank pain in April 2010. He was evaluated in the emergency department when the pain had persisted for 3 weeks. He reported worsening of the pain in the evening and difficulty with ejaculation since the pain began: "I get a knot in my side," then "I can't ejaculate." He also reported associated low back pain and increased pain with bending to his left. His general physical examination was unremarkable. Urine analysis demonstrated 30 mg/dl protein, 10 mg/dl ketones, 8 mg/dl urobilinogen (reference value Ͻ2.0), 8 red blood cells/ high-power field (hpf), 2 white blood cells/hpf, and mucous. He was prescribed ibuprofen for abdominal pain and was advised to follow up with his primary care provider.The pain persisted. He saw his primary provider in July with worsening epigastric and left-sided abdominal and flank pain. By this time, he had decreased appetite, early satiety, and weight loss of 22 pounds. His primary provider ordered a computed tomographic (CT) scan of his abdomen and pelvis, which demonstrated a rind of soft tissue in the retroperitoneum surrounding the aorta and inferior vena cava and wall thickening of the sigmoid colon and rectum. A biopsy of the mass was done by interventional radiology at another hospital. Since his pain was unrelieved by acetaminophen/hydrocodone, he was admitted to our hospital for further evaluation and pain control. He did not know the results of the biopsy. Medical HistoryHe had been relatively healthy prior to the onset of illness in April. Atheromatous calcification of the aorta with mild ectasia inferiorly measuring up to 2.3 cm in diameter was noted incidentally on a CT scan obtained to evaluate for ureteral calculi in September 2008. He had a remote history of gonorrhea and chlamydia infections, which were treated. He had been seen in the emergency department for right testicular pain following trauma at age 35 years and left testicular pain without clear etiology at ages 40 and 43 years. The first episode of left testicular pain was attributed to epididymitis. The second was attributed to suspected passage of a ureteral calculus. Social and Family HistoryThe patient's family history was negative for rheumatic disorders. Several family members, including his mother, had diabetes mellitus and hypertension. His sister had thyroid disease. He was unemployed, but previously worked as a baker. He smoked one-quarter of a pack of cigarettes per day for several years, and previously smoked marijuana. He consumed, on average, 1 alcoholic beverage per week and denied intravenous drug use. He was sexually active and did not consistently use barrier protection. Review of SystemsThe patient reported persistent inability to ejaculate, without decrease in arousal or orgasm and without associated pain. He also reported low back pain that preceded his current illness by years. He had constipation for 2 weeks.

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Evidence of autoimmunity in chronic periaortitis: a prospective study

Cited by 191 publications

References 22 publications

Positron emission tomography (PET): Evaluation of chronic periaortitis

Positron emission tomography (PET): Evaluation of chronic periaortitis

¹⁸F‐fluorodeoxyglucose positron emission tomography in the diagnosis and followup of idiopathic retroperitoneal fibrosis

A 45‐year‐old man with flank pain and inability to ejaculate

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Evidence of autoimmunity in chronic periaortitis: a prospective study

Cited by 191 publications

References 22 publications

Positron emission tomography (PET): Evaluation of chronic periaortitis

Positron emission tomography (PET): Evaluation of chronic periaortitis

18F‐fluorodeoxyglucose positron emission tomography in the diagnosis and followup of idiopathic retroperitoneal fibrosis

A 45‐year‐old man with flank pain and inability to ejaculate

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¹⁸F‐fluorodeoxyglucose positron emission tomography in the diagnosis and followup of idiopathic retroperitoneal fibrosis