TY - JOUR
T1 - Clinically isolated descending thoracic aortitis in a healthy older woman
T2 - A diagnostic challenge
AU - Hoffman, Max Amos
AU - Ekladious, Adel
PY - 2021/2/18
Y1 - 2021/2/18
N2 - A woman travelling to Australia in her early 70s presents to a regional emergency department with chest pain and associated shortness of breath. Her medical history was that of seasonal affective disorder treated with citalopram, and an allergy to ibuprofen. Subsequent CT imaging revealed aortic wall thickening and associated periaortic fluid, and a moderate pleural effusion. This was successfully treated with oral prednisolone, responding within 1 day. Further blood tests revealed a high CD4/CD8 T-cell ratio, which can be seen in autoimmune disease, sarcoidosis and haematological malignancies. Without evidence for other autoimmune processes, the patient was given a provisional diagnosis of descending thoracic aortitis secondary to sarcoidosis, prescribed a weaning regimen of prednisolone, and asked to seek further investigation and management in her home country. This is a case with several learning points; rare disease can cause common presentations/reports, and sometimes empirical therapy is the only therapy.
AB - A woman travelling to Australia in her early 70s presents to a regional emergency department with chest pain and associated shortness of breath. Her medical history was that of seasonal affective disorder treated with citalopram, and an allergy to ibuprofen. Subsequent CT imaging revealed aortic wall thickening and associated periaortic fluid, and a moderate pleural effusion. This was successfully treated with oral prednisolone, responding within 1 day. Further blood tests revealed a high CD4/CD8 T-cell ratio, which can be seen in autoimmune disease, sarcoidosis and haematological malignancies. Without evidence for other autoimmune processes, the patient was given a provisional diagnosis of descending thoracic aortitis secondary to sarcoidosis, prescribed a weaning regimen of prednisolone, and asked to seek further investigation and management in her home country. This is a case with several learning points; rare disease can cause common presentations/reports, and sometimes empirical therapy is the only therapy.
KW - cardiovascular medicine
KW - travel medicine
KW - vasculitis
UR - http://www.scopus.com/inward/record.url?scp=85101205743&partnerID=8YFLogxK
U2 - 10.1136/bcr-2020-238009
DO - 10.1136/bcr-2020-238009
M3 - Article
C2 - 33602759
AN - SCOPUS:85101205743
VL - 14
JO - B.M.J. Case Reports
JF - B.M.J. Case Reports
SN - 1757-790X
IS - 2
M1 - 238009
ER -