Aortitis is the

inflammation Inflammation (from la, wikt:en:inflammatio#Latin, inflammatio) is part of the complex biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or Irritation, irritants, and is a protective response involving im ...

of the aortic wall. The disorder is potentially life-threatening and rare. It is reported that there are only 1–3 new cases of aortitis per year per million people in the United States and Europe. Aortitis is most common in people 10 to 40 years of age.

Causes

This

has a number of possible causes, including trauma,

viral Viral means "relating to viruses" (small infectious agents). Viral may also refer to: Viral behavior, or virality Memetic behavior likened that of a virus, for example: * Viral marketing, the use of existing social networks to spread a marke ...

or bacterial infections (notably, syphilis), and certain immune disorders and

connective tissue disease A connective tissue disease (collagenosis) is any disease that has the connective tissues of the body as a target of pathology. Connective tissue is any type of biological tissue with an extensive extracellular matrix that supports, binds togeth ...

s. Aortitis is most commonly seen in patients with syphilis, autoimmune vasculitis ( giant cell arteritis, Takayasu's arteritis), polymyalgia rheumatica, and

rheumatoid arthritis Rheumatoid arthritis (RA) is a long-term autoimmune disorder that primarily affects synovial joint, joints. It typically results in warm, swollen, and painful joints. Pain and stiffness often worsen following rest. Most commonly, the wrist and ...

. aber's Cyclopedic Medical Dictionary. 19th ed. Philadelphia: F.A. Davis, 2001./ref> IgG4-related disease has more recently been identified as a cause of aortitis, and also as a cause of periaortitis (inflammation ''surrounding'' the aorta). There is a wide range of symptoms that are dependent on the location of the aortic inflammation or associated disorder. A few symptoms recognized in patients are

fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...

, chills, muscle pains, and malaise (general discomfort). In addition, hypertension (high blood pressure) may occur. Hypertension happens when the

renal artery The renal arteries are paired arteries that supply the kidneys with blood. Each is directed across the crus of the diaphragm, so as to form nearly a right angle. The renal arteries carry a large portion of total blood flow to the kidneys. Up to ...

narrows and elasticity of the aorta and branches decrease.Link text
American Heart Association. Aortitis can also be caused by ''

Salmonella ''Salmonella'' is a genus of rod-shaped (bacillus) Gram-negative bacteria of the family Enterobacteriaceae. The two species of ''Salmonella'' are ''Salmonella enterica'' and '' Salmonella bongori''. ''S. enterica'' is the type species and is fur ...

'' infection.

Diagnosis

Diagnosis of aortitis starts with

physical examination In a physical examination, medical examination, or clinical examination, a medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition. It generally consists of a series of questions about the patie ...

and recording patient's medical history. Imaging tests such as magnetic resonance angiography,

doppler ultrasonography Doppler ultrasonography is medical ultrasonography that employs the Doppler effect to perform imaging of the movement of tissues and body fluids (usually blood), and their relative velocity to the probe. By calculating the frequency shift of ...

, and

positron emission tomography Positron emission tomography (PET) is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, ...

(PET) can be used to look at the blood vessels and blood flow, and highlight areas of inflammation. Condition is generally diagnosed based on the symptoms the patient is experiencing and the aortic images.

Treatment

Treatment of aortitis depends on the underlying cause. The initial treatment of suspected infectious aortitis is intravenous antibiotics with broad antimicrobial coverage of the most likely pathologic organisms, In contrast, immunosuppressive therapy is the primary treatment of non-infectious aortitis due to large-vessel vasculitis, and patients are ideally managed by a multi-disciplinary team that includes a rheumatologist and medical and surgical cardiovascular specialists. Once the diagnosis of non-infectious aortitis due to GCA or Takayasu arteritis has been established, oral glucocorticoid therapy should be initiated. Frequently, adjunctive immunosuppressants, including methotrexate and azathioprine, are paired with steroids to treat refractory disease or to minimize steroid-induced adverse effects. Management includes the following treatment priorities: stop the

, treat complications, prevent and monitor for re-occurrence.

Prognosis

If untreated, has three distinct phases. The first is a prepulseless inflammatory stage with nonspecific symptoms such as fatigue, arthralgias, and low-grade fevers. Phase two includes vascular inflammation with pain secondary to the condition, along with tenderness to palpation over the site. The last phase includes symptoms of

ischemia Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems ...

and pain associated with the use of limbs. Limbs are also cool and clammy in this stage.

References

External links

{{Vascular diseases Vascular diseases IgG4-related disease