TIPIC Syndrome: Beyond the Myth of Carotidynia, a New Distinct Unclassified Entity

Lecler, Augustin; Obadia, Michaël; Savatovsky, Julien; Picard, Hervé; Charbonneau, F.; Champfleur, Nicolas Menjot de; Naggara, Olivier; Carsin, Béatrice; Amor-Sahli, M.; Cottier, J.-P.; Bensoussan, J.-J.; Auffray-Calvier, E.; Varoquaux, A.; Gaalon, S. de; Calazel, C.; Nasr, Nathalie; Volle, Geoffroy; Jianu, Dragoș Cătălin; Gout, Olivier; Bonneville, Fabrice; Sadik, Jean-Claude

doi:10.3174/ajnr.a5214

Cited by 93 publications

(164 citation statements)

References 20 publications

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“…However, our case and the past studies reported cases have demonstrated one or more of the following abnormal imaging findings: involvement of a contiguous segment of the distal common carotid artery, bulb, or proximal internal carotid artery, mild luminal narrowing, concentric thickening or outward extension of the wall, or fat stranding in the adjacent carotid space. As we did not try other images such as MRI in this time, we cannot discuss the findings of other images [4,[9][10][11][12][13]. Our patient also had abnormal findings on ultrasonography, including a hypoechoic change of the outside wall of the carotid artery and moderate thickening of endothelium with subsequent slight narrowing of the vessel lumen.…”

Section: Discussionmentioning

confidence: 88%

Recurrent TransIent Perivascular Inflammation of the Carotid artery syndrome with temporary carotid plaque on ultrasonography: a case report

Takamura

Hori

2017

Clinical Case Reports

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Key Clinical MessageTransIent Perivascular Inflammation of the Carotid artery (TIPIC) syndrome is a rare syndrome with an unknown cause that is characterized by unilateral neck pain. Its existence as a pathological entity was controversial. We describe a 44‐year‐old male presenting with a 10‐day history of right neck pain diagnosed recurrent TIPIC syndrome with temporary carotid plaque followed by ultrasonography.

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Section: Discussionmentioning

confidence: 88%

Recurrent TransIent Perivascular Inflammation of the Carotid artery syndrome with temporary carotid plaque on ultrasonography: a case report

Takamura

Hori

2017

Clinical Case Reports

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“…TIPIC is a newly recognized syndrome that describes a distinct clinico-radiologic entity, previously diagnosed as idiopathic carotidynia (IC) [2,7,8]. In a recent multicenter study, Lecler et al proposed that TIPIC syndrome should be added to the International Classification of Headache Disorders-III [9] based on the following four major criteria: (1) presence of acute pain overlying the carotid artery, which may or may not radiate to the head, (2) eccentric perivascular infiltration (PVI) on imaging, (3) exclusion of another vascular or nonvascular diagnosis with imaging, and (4) improvement within 14 days either spontaneously or with anti-inflammatory treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent multicenter study, Lecler et al proposed that TIPIC syndrome should be added to the International Classification of Headache Disorders-III [9] based on the following four major criteria: (1) presence of acute pain overlying the carotid artery, which may or may not radiate to the head, (2) eccentric perivascular infiltration (PVI) on imaging, (3) exclusion of another vascular or nonvascular diagnosis with imaging, and (4) improvement within 14 days either spontaneously or with anti-inflammatory treatment. Additionally, Lecler et al stated that a minor criterion could be the presence of a self-limited intimal soft plaque [7].…”

Section: Discussionmentioning

confidence: 99%

“…It was therefore deemed necessary to improve upon the description of this clinico-radiologic entity [5,6]. On this background, in a multicenter study conducted in 2017, Lecler et al have described this unclassified entity by the acronym: transient perivascular inflammation of the carotid artery (TIPIC) syndrome [7]. It responds to anti-inflammatory medications and is known to have a benign course [7].…”

Section: Introductionmentioning

confidence: 99%

“…On this background, in a multicenter study conducted in 2017, Lecler et al have described this unclassified entity by the acronym: transient perivascular inflammation of the carotid artery (TIPIC) syndrome [7]. It responds to anti-inflammatory medications and is known to have a benign course [7]. Therefore, determination of an accurate diagnosis of this syndrome is imperative for its appropriate clinical management.…”

Section: Introductionmentioning

confidence: 99%

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Role of Ultrasound in the Diagnosis and Follow-Up of Transient Perivascular Inflammation of the Carotid Artery (TIPIC) Syndrome: a Case Report

Monga

Vakharia

Hastak

et al. 2019

SN Compr. Clin. Med.

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Idiopathic carotidynia (IC) is a rare, possibly under-diagnosed clinico-radiologic entity that consists of acute unilateral neck pain and tenderness over the carotid bifurcation. Lecler et al. have recently described this condition associated with characteristic imaging features of transient perivascular soft tissue inflammation at the level of the affected carotid bifurcation, by a new term TIPIC (transient perivascular inflammation of the carotid artery) syndrome. We report the case of an Indian man, with recurrent right-sided TIPIC syndrome and past history of transient left-sided symptoms. On initial presentation, the clinical history, ultrasound (US) features, magnetic resonance imaging (MRI) findings, and laboratory investigations of the patient were correlated to establish the diagnosis of TIPIC syndrome. Doppler US was performed for imaging follow-up of this patient, when he presented again with recurrence of similar symptoms of right neck pain. In this 45-year-old patient, US demonstrated a characteristic perivascular echogenic soft tissue around the symptomatic carotid artery. MRI confirmed these imaging findings and ruled out carotid dissection. Patient responded to antiinflammatory medications. Recurrence and resolution of the soft tissue thickening surrounding the affected carotid arteries were documented on serial follow-up US examinations. This case report illustrates that US can be effectively used in the diagnosis as well as follow-up of TIPIC syndrome.

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G‐CSF‐induced TIPIC syndrome and large vessel vasculitis: A case report

Arnould,

Miranda,

Mignon

et al. 2023

Clinical Case Reports

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Key Clinical MessageWe report a rare adverse event of transient perivascular inflammation of the carotid artery syndrome induced by granulocyte colony‐stimulating factor injections. Recognition of this syndrome is important for physicians, to avoid the exposure of the causative medication, rule out differential diagnosis and delay the use of corticosteroids given the spontaneous improvement after discontinuation of the causative medication.AbstractA 73 year‐old Caucasian woman presented with odynophagia, carotidynia, and fever 5 days following a granulocyte colony‐stimulating factor (G‐CSF) injection for chemotherapy‐induced neutropenia in the setting of myelodysplastic syndrome. Examination showed painful swelling of the neck. Lab results showed inflammation with CRP 328 mg/L. A CT‐scan revealed tissue infiltration thickening surrounding the left internal carotid artery, the carotid bifurcation, and the common carotid artery, as well as circumferential thickening of the aortic arch. Ultrasound of the left internal carotid artery found isoechoic wall thickening. Symptoms drastically improved without steroids in a short time period. Horton's disease, Takayasu's diseases, and infectious vasculitis were not retained due to the short time delay of symptoms onset, atypical echogenicity, and spontaneous improvement. A diagnosis of G‐CSF‐induced large vessel vasculitis transient perivascular inflammation of the carotid artery (TIPIC) syndrome was made. Seven days later, ultrasound control showed diminished thickening infiltration. G‐CSF TIPIC is a rare adverse event that should be kept in mind in patients under G‐CSF.

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TIPIC Syndrome: Beyond the Myth of Carotidynia, a New Distinct Unclassified Entity

Abstract: Our study improved the description of an unclassified, clinico-radiologic entity, which could be described by the proposed acronym: TransIent Perivascular Inflammation of the Carotid artery (TIPIC) syndrome.

Cited by 93 publications

References 20 publications

Recurrent TransIent Perivascular Inflammation of the Carotid artery syndrome with temporary carotid plaque on ultrasonography: a case report

Recurrent TransIent Perivascular Inflammation of the Carotid artery syndrome with temporary carotid plaque on ultrasonography: a case report

Role of Ultrasound in the Diagnosis and Follow-Up of Transient Perivascular Inflammation of the Carotid Artery (TIPIC) Syndrome: a Case Report

G‐CSF‐induced TIPIC syndrome and large vessel vasculitis: A case report

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