Segmental mediolytic arteriopathy of the splenic and hepatic arteries mimicking systemic necrotizing vasculitis

Chan, Roland J.; Goodman, Thomas A.; Aretz, Thomas; Lie, J.T.

doi:10.1002/1529-0131(199805)41:5<935::aid-art22>3.0.co;2-n

Cited by 58 publications

(29 citation statements)

References 7 publications

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“…A subsequent review of the resected vessel led to the correct diagnosis of segmental mediolytic arteriopathy, a variant of fibromuscular dysplasia. [30]. All these cases had an acute presentation with radiologic and laboratory features suggesting a vasculitic process.…”

Section: Fibromuscular Dysplasiamentioning

confidence: 96%

Pseudovasculitis: Mechanisms of vascular injury and clinical spectrum

Grau

2002

Curr Rheumatol Rep

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Pseudovasculitis, vasculitis-like syndromes, or mimics of vasculitis represent a heterogeneous collection of disorders that are capable of simulating a vasculitic disorder. Some conditions such as cardiac myxomas, cholesterol embolization, and fibromuscular dysplasia are more apt to cause confusion, but numerous other conditions can do so also. Inappropriate diagnosis leads to delay or absence of proper management and exposure to potentially deleterious treatment modalities such as corticosteroids and cytotoxic agents. The diagnosis of a pseudovasculitic disorder requires a high index of suspicion and should always be part of the differential diagnosis of vasculitis. The endothelium is thought to be pivotal in vascular injury; much has been learned using in vitro human umbilical vein endothelial cell cultures. Application of this knowledge to human disease and to vasculitic disorders and their imitators is still premature.

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Section: Fibromuscular Dysplasiamentioning

confidence: 96%

Pseudovasculitis: Mechanisms of vascular injury and clinical spectrum

Grau

2002

Curr Rheumatol Rep

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“…Surgical or interventional repair of aneurysms and endovascular stenting of arterial dissections may be necessary. Because of the similarity of SMA to polyarteritis nodosa, surgery with histopathological analysis for better differentiation has been proposed [15]. Considering the normally perfused mesenteric vessels, hypoperfusion due to low cardiac output is the most probable cause of the bowel ischemia in this case Fig.…”

Section: Segmental Mediolytic Arteriopathymentioning

confidence: 97%

Multislice CT in the pre- and postinterventional evaluation of mesenteric perfusion

et al. 2005

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Multislice computed tomography angiography (CTA) has been found feasible for the evaluation of visceral vasculature. The development of multislice technology has overcome past limitations. First, the faster scanning speed increases volume coverage during a single breath-hold and improves the exploitation of contrast medium. Second, the better spatial resolution results in nearly isotropic voxels allowing reconstruction of high-resolution threedimensional images with different algorithms. Volume rendering is capable of displaying the visceral vasculature from any external vantage point. Compared to conventional angiography, CTA not only delineates vessels but also depicts the anatomical relationship to adjacent structures and allows the evaluation of perfused organs. CTA also has become an emerging tool for the pre-and postinterventional assessment of vascular anatomy. The purpose of this pictorial essay is to present a spectrum of visceral vascular diseases and interventional and surgical therapies, and to highlight the role of postprocessing for their evaluation.

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“…47,50,53 The differential diagnosis of SAM includes vasculitides (mainly PAN, Behç et disease, and TAK), mycotic aneurysm, and noninflammatory vasculopathies such as FMD, Ehlers-Danlos syndrome type IV, cystic adventitial artery disease, and cystic medial necrosis (eg, Marfan syndrome). 54,55 No serum or genetic biomarker is available for the diagnosis of SAM.…”

Section: Segmental Arterial Mediolysismentioning

confidence: 99%