Aortitis as a Harbinger of Occult Malignancy
Noninfectious aortitis can be associated with an occult malignancy. Although glucocorticosteroids are often used, there is no clear evidence-based therapy and there is little consensus regarding treatment. Identifying and treating an underlying trigger is the most efficacious therapy. We present an...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2019/8385630 |
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| _version_ | 1850165179792228352 |
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| author | Erik W. O’Connell Jennifer Reams Alfred E. Denio |
| author_facet | Erik W. O’Connell Jennifer Reams Alfred E. Denio |
| author_sort | Erik W. O’Connell |
| collection | DOAJ |
| description | Noninfectious aortitis can be associated with an occult malignancy. Although glucocorticosteroids are often used, there is no clear evidence-based therapy and there is little consensus regarding treatment. Identifying and treating an underlying trigger is the most efficacious therapy. We present an unusual case initially concerning acute bacterial endocarditis of the native mitral valve; however, aseptic ischemic valvitis manifested on pathology. Concurrent aortitis was diagnosed with angiography. Occult colon adenocarcinoma was discovered during diagnostic abdominal imaging. Treatment of this underlying malignancy was associated with dynamic mitigation of inflammation affecting the entire aorta and a reduction in associated symptoms. This is an unusual case of a paraneoplastic secondary large vessel vasculitis involving the entire aorta, a diagnosis of exclusion but a consideration that can have dramatic impact on both morbidity and mortality. |
| format | Article |
| id | doaj-art-ec6474b39e944108adfb7bc583ba89c1 |
| institution | OA Journals |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-ec6474b39e944108adfb7bc583ba89c12025-08-20T02:21:49ZengWileyCase Reports in Rheumatology2090-68892090-68972019-01-01201910.1155/2019/83856308385630Aortitis as a Harbinger of Occult MalignancyErik W. O’Connell0Jennifer Reams1Alfred E. Denio2Division of Rheumatology MC 2152, Geisinger Medical Center, 100 N Academy Ave., Danville, PA 17822, USADivision of Rheumatology MC 2152, Geisinger Medical Center, 100 N Academy Ave., Danville, PA 17822, USADivision of Rheumatology MC 2152, Geisinger Medical Center, 100 N Academy Ave., Danville, PA 17822, USANoninfectious aortitis can be associated with an occult malignancy. Although glucocorticosteroids are often used, there is no clear evidence-based therapy and there is little consensus regarding treatment. Identifying and treating an underlying trigger is the most efficacious therapy. We present an unusual case initially concerning acute bacterial endocarditis of the native mitral valve; however, aseptic ischemic valvitis manifested on pathology. Concurrent aortitis was diagnosed with angiography. Occult colon adenocarcinoma was discovered during diagnostic abdominal imaging. Treatment of this underlying malignancy was associated with dynamic mitigation of inflammation affecting the entire aorta and a reduction in associated symptoms. This is an unusual case of a paraneoplastic secondary large vessel vasculitis involving the entire aorta, a diagnosis of exclusion but a consideration that can have dramatic impact on both morbidity and mortality.http://dx.doi.org/10.1155/2019/8385630 |
| spellingShingle | Erik W. O’Connell Jennifer Reams Alfred E. Denio Aortitis as a Harbinger of Occult Malignancy Case Reports in Rheumatology |
| title | Aortitis as a Harbinger of Occult Malignancy |
| title_full | Aortitis as a Harbinger of Occult Malignancy |
| title_fullStr | Aortitis as a Harbinger of Occult Malignancy |
| title_full_unstemmed | Aortitis as a Harbinger of Occult Malignancy |
| title_short | Aortitis as a Harbinger of Occult Malignancy |
| title_sort | aortitis as a harbinger of occult malignancy |
| url | http://dx.doi.org/10.1155/2019/8385630 |
| work_keys_str_mv | AT erikwoconnell aortitisasaharbingerofoccultmalignancy AT jenniferreams aortitisasaharbingerofoccultmalignancy AT alfrededenio aortitisasaharbingerofoccultmalignancy |