A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report
Key Clinical Message Clinicians should be aware of rare manifestations of AS, while considering a low threshold for screening vascular involvement in an axial SpA/nrxSpA/AS presenting with unexplained fevers and significant constitutional symptoms and elevated markers. Abstract Ankylosing spondyliti...
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| Format: | Article |
| Language: | English |
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Wiley
2023-11-01
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| Series: | Clinical Case Reports |
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| Online Access: | https://doi.org/10.1002/ccr3.8207 |
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| author | Mahsa Mehdipour Dalivand Rezvan Abdolazimi Reyhaneh Manafi‐Farid Ahmadreza Jamshidi Kimia Kassaee Sara Foolad Majid Alikhani |
| author_facet | Mahsa Mehdipour Dalivand Rezvan Abdolazimi Reyhaneh Manafi‐Farid Ahmadreza Jamshidi Kimia Kassaee Sara Foolad Majid Alikhani |
| author_sort | Mahsa Mehdipour Dalivand |
| collection | DOAJ |
| description | Key Clinical Message Clinicians should be aware of rare manifestations of AS, while considering a low threshold for screening vascular involvement in an axial SpA/nrxSpA/AS presenting with unexplained fevers and significant constitutional symptoms and elevated markers. Abstract Ankylosing spondylitis (AS) is a chronic inflammatory disease from the spondyloarthritis complex, which usually affects young men and primarily involves sacroiliac joints and the spine. It can also present with non‐joint involvement, such as cardiovascular manifestations. Aortitis is a rare yet critical cardiovascular complication associated with AS, which can lead to life‐threatening outcomes when undiagnosed. Here we report a 34‐year‐old man with intermittent fevers and significant weight loss, myalgia, and arthralgia for 1 year before being referred to our hospital due to undefinable causes despite multiple diagnostic efforts. The patient presented with elevated inflammatory markers and involvement of sacroiliac joints in favor of the AS. A positron emission tomography scan was also done to rule out underlying malignancy, which led to the detection of inflammation in ascending aorta, compatible with aortitis. The patient was treated with nonsteroidal anti‐inflammatory drugs, prednisolone, and infliximab, and his signs and symptoms significantly improved. Our case reports a rare but substantial complication of AS, in a young patient without a history of prolonged disease presenting with unspecific manifestations. The implantation of a thorough examination of AS patients, including cardiac examinations, could contribute to faster and more efficient diagnosis and treatment. |
| first_indexed | 2024-03-09T14:29:23Z |
| format | Article |
| id | doaj.art-0858a93cbbd9412db31bb7c46ee8d6f4 |
| institution | Directory Open Access Journal |
| issn | 2050-0904 |
| language | English |
| last_indexed | 2024-03-09T14:29:23Z |
| publishDate | 2023-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical Case Reports |
| spelling | doaj.art-0858a93cbbd9412db31bb7c46ee8d6f42023-11-28T04:14:45ZengWileyClinical Case Reports2050-09042023-11-011111n/an/a10.1002/ccr3.8207A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case reportMahsa Mehdipour Dalivand0Rezvan Abdolazimi1Reyhaneh Manafi‐Farid2Ahmadreza Jamshidi3Kimia Kassaee4Sara Foolad5Majid Alikhani6Rheumatology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran IranDepartment of Internal Medicine, Shariati Hospital Tehran University of Medical Sciences Tehran IranResearch Center for Nuclear Medicine, Shariati Hospital Tehran University of Medical Sciences Tehran IranRheumatology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran IranSchool of Medicine Iran University of Medical Sciences Tehran IranCollege of Agricultural Sciences, Shiraz Branch Islamic Azad University Shiraz IranRheumatology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran IranKey Clinical Message Clinicians should be aware of rare manifestations of AS, while considering a low threshold for screening vascular involvement in an axial SpA/nrxSpA/AS presenting with unexplained fevers and significant constitutional symptoms and elevated markers. Abstract Ankylosing spondylitis (AS) is a chronic inflammatory disease from the spondyloarthritis complex, which usually affects young men and primarily involves sacroiliac joints and the spine. It can also present with non‐joint involvement, such as cardiovascular manifestations. Aortitis is a rare yet critical cardiovascular complication associated with AS, which can lead to life‐threatening outcomes when undiagnosed. Here we report a 34‐year‐old man with intermittent fevers and significant weight loss, myalgia, and arthralgia for 1 year before being referred to our hospital due to undefinable causes despite multiple diagnostic efforts. The patient presented with elevated inflammatory markers and involvement of sacroiliac joints in favor of the AS. A positron emission tomography scan was also done to rule out underlying malignancy, which led to the detection of inflammation in ascending aorta, compatible with aortitis. The patient was treated with nonsteroidal anti‐inflammatory drugs, prednisolone, and infliximab, and his signs and symptoms significantly improved. Our case reports a rare but substantial complication of AS, in a young patient without a history of prolonged disease presenting with unspecific manifestations. The implantation of a thorough examination of AS patients, including cardiac examinations, could contribute to faster and more efficient diagnosis and treatment.https://doi.org/10.1002/ccr3.8207ankylosingaortitisarthralgiacase reportspondylitisspondyloarthritis |
| spellingShingle | Mahsa Mehdipour Dalivand Rezvan Abdolazimi Reyhaneh Manafi‐Farid Ahmadreza Jamshidi Kimia Kassaee Sara Foolad Majid Alikhani A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report Clinical Case Reports ankylosing aortitis arthralgia case report spondylitis spondyloarthritis |
| title | A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report |
| title_full | A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report |
| title_fullStr | A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report |
| title_full_unstemmed | A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report |
| title_short | A case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis: A case report |
| title_sort | case of ankylosing spondylitis presenting with fever of unknown origin diagnosed as aortitis a case report |
| topic | ankylosing aortitis arthralgia case report spondylitis spondyloarthritis |
| url | https://doi.org/10.1002/ccr3.8207 |
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