Korean Circulation Journal

  • 제42권12호
  • /
  • Pages.857-860
  • /
  • 2012
  • /
  • 1738-5520(pISSN)
  • /
  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
권호 표지
DOI QR코드

DOI QR Code

A Case of Chronic Periaortitis with Retroperitoneal Fibrosis

  • Park, Sun Hee (Department of Cardiology, Kyungpook National University Hospital) ;
  • Im, Churl Hyun (Department of Rheumatology, Kyungpook National University Hospital) ;
  • Yang, Dong Heon (Department of Cardiology, Kyungpook National University Hospital) ;
  • Kang, Jong Wan (Department of Rheumatology, Kyungpook National University Hospital) ;
  • Yoon, Jae Yong (Department of Cardiology, Kyungpook National University Hospital) ;
  • Cho, Hyun Jun (Department of Cardiology, Kyungpook National University Hospital) ;
  • Park, Hun Sik (Department of Cardiology, Kyungpook National University Hospital) ;
  • Cho, Yongkeun (Department of Cardiology, Kyungpook National University Hospital) ;
  • Chae, Shung Chull (Department of Cardiology, Kyungpook National University Hospital) ;
  • Jun, Jae-Eun (Department of Cardiology, Kyungpook National University Hospital)
  • 발행 : 2012.12.31
⟨ 이전 논문 다음 논문 ⟩

초록

A 73-year-old man with a history of hypertension and ascending aortic dissection was hospitalized for aggravated abdominal pain and general ache for 3 months. Follow-up CT showed aggravated abdominal aortic hematoma with aneurysm, atherosclerotic periaortitis and bilateral hydronephrosis. An initial laboratory finding showed elevated levels of inflammatory markers and renal dysfunction. Positron emission tomography-CT showed an increased standardized uptake values level in the aortic arch, descending thoracic aorta, major branch, abdominal aorta, and common iliac artery. For bilateral hydronephrosis, a double J catheter insertion was performed. Tissue specimens obtained from previous surgery on the aorta indicated the infiltration of lympho-plasma cells without granuloma formation in the aortic wall. After a combined therapy of high dose steroid therapy with azathioprine, the patient's initial complaints of abdominal pain, weakness and azotemia improved. This case was diagnosed as chronic periaortitis based on aortic inflammation at biopsy, which was complicated with retroperitoneal fibrosis and ureteric obstruction.

키워드

참고문헌

  1. Mitchinson MJ. Chronic periaortitis and periarteritis. Histopathology 1984;8:589-600. https://doi.org/10.1111/j.1365-2559.1984.tb02371.x
  2. Parums DV. The spectrum of chronic periaortitis. Histopathology 1990;16:423-31.
  3. Vaglio A, Buzio C. Chronic periaortitis: a spectrum of diseases. Curr Opin Rheumatol 2005;17:34-40. https://doi.org/10.1097/01.bor.0000145517.83972.40
  4. Jois RN, Gaffney K, Marshall T, Scott DG. Chronic periaortitis. Rheumatology (Oxford) 2004;43:1441-6. https://doi.org/10.1093/rheumatology/keh326
  5. Vaglio A, Corradi D, Manenti L, Ferretti S, Garini G, Buzio C. Evidence of autoimmunity in chronic periaortitis: a prospective study. Am J Med 2003;114:454-62. https://doi.org/10.1016/S0002-9343(03)00056-1
  6. Vaglio A, Greco P, Corradi D, et al. Autoimmune aspects of chronic periaortitis. Autoimmun Rev 2006;5:458-64. https://doi.org/10.1016/j.autrev.2006.03.011
  7. Van Bommel EF, Jansen I, Hendriksz TR, Aarnoudse AL. Idiopathic retroperitoneal fibrosis: prospective evaluation of incidence and clinicoradiologic presentation. Medicine (Baltimore) 2009;88:193-201. https://doi.org/10.1097/MD.0b013e3181afc420
  8. Vaglio A, Pipitone N, Salvarani C. Chronic periaortitis: a large-vessel vasculitis? Curr Opin Rheumatol 2011;23:1-6. https://doi.org/10.1097/BOR.0b013e328341137d
  9. Stone JH, Khosroshahi A, Hilgenberg A, Spooner A, Isselbacher EM, Stone JR. IgG4-related systemic disease and lymphoplasmacytic aortitis. Arthritis Rheum 2009;60:3139-45. https://doi.org/10.1002/art.24798
  10. Sakamoto A, Nagai R, Saito K, et al. Idiopathic retroperitoneal fibrosis, inflammatory aortic aneurysm, and inflammatory pericarditis: retrospective analysis of 11 case histories. J Cardiol 2012;59:139-46. https://doi.org/10.1016/j.jjcc.2011.07.014
  11. Iino M, Kuribayashi S, Imakita S, et al. Sensitivity and specificity of CT in the diagnosis of inflammatory abdominal aortic aneurysms. J Comput Assist Tomogr 2002;26:1006-12. https://doi.org/10.1097/00004728-200211000-00026
  12. Blockmans D, Van Moer E, Dehem J, Feys C, Mortelmans L. Positron emission tomography can reveal abdominal periaortitis. Clin Nucl Med 2002;27:211-2. https://doi.org/10.1097/00003072-200203000-00016
  13. Kardar AH, Kattan S, Lindstedt E, Hanash K. Steroid therapy for idiopathic retroperitoneal fibrosis: dose and duration. J Urol 2002;168:550-5. https://doi.org/10.1016/S0022-5347(05)64677-0