OBJECTIVE: Chronic periaortitis (CP) is a rare disease characterized by fibro-inflammatory tissue surrounding the abdominal aorta and the iliac arteries. Anecdotal reports have shown that CP may also involve other vascular districts, particularly the thoracic aorta. The aim of this study was to investigate the thoracic aorta and epiaortic artery involvement in CP. METHODS: Patients were eligible if they had undergone imaging studies assessing inflammatory involvement of the thoracic aorta and its major branches (e.g. contrast CT, MRI or PET-CT). We explored the patterns of thoracic vessel involvement and compared the clinical characteristics of patients with and without thoracic disease. Where available, we also reviewed the thoracic vascular/perivascular tissue biopsies. RESULTS: Of 153 CP patients seen between 1999 and 2012, 77 were eligible. Of these, 28 (36%) had thoracic involvement: 15 (54%) had thoracic periaortitis, with 7 also showing epiaortic artery involvement; 6 (21%) had periaortitis surrounding a thoracic aortic aneurysm, 2 of them with epiaortic artery involvement; 7 (25%) had a thoracic aortic aneurysm without periaortitis. Patients with thoracic disease were more frequently female (P = 0.01), were older (P = 0.001) and had a higher frequency of pain and constitutional symptoms (P = 0.02). Thoracic (peri)vascular biopsies revealed adventitial and peri-adventitial fibro-inflammatory patterns similar to those observed in abdominal CP. CONCLUSION: In about one-third of patients, CP also involves the thoracic aorta and the epiaortic arteries, which supports the hypothesis of a systemic inflammatory disease of the large arteries.
Chronic periaortitis with thoracic aorta and epiaortic artery involvement : a systemic large vessel vasculitis? / A. Palmisano, M.L. Urban, D. Corradi, R. Cobelli, F. Alberici, F. Maritati, A. Versari, N. Pipitone, C. Salvarani, C. Buzio, A. Vaglio. - In: RHEUMATOLOGY. - ISSN 1462-0324. - 54:11(2015 Nov), pp. 2004-2009.
|Titolo:||Chronic periaortitis with thoracic aorta and epiaortic artery involvement : a systemic large vessel vasculitis?|
|Parole Chiave:||aneurysms; aorta; giant cell arteritis; periaortitis; retroperitoneal fibrosis; vasculitis; Age Factors; Aged; Aorta; Aorta, Thoracic; Aortography; Biopsy; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Retroperitoneal Fibrosis; Retrospective Studies; Sex Factors; Systemic Vasculitis; Thoracic Diseases; Tomography, X-Ray Computed|
|Settore Scientifico Disciplinare:||Settore MED/14 - Nefrologia|
|Data di pubblicazione:||nov-2015|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1093/rheumatology/kev225|
|Appare nelle tipologie:||01 - Articolo su periodico|