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...

Full description

Saved in:
Bibliographic Details
Main Authors: Erik W. O’Connell, Jennifer Reams, Alfred E. Denio
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Rheumatology
Online Access:http://dx.doi.org/10.1155/2019/8385630
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850165179792228352
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