[Takayasu's arteritis without manifest arterial stenoses as a cause of fever of unknown origin].

Abstract

HISTORY AND CLINICAL FINDINGS:

Two women, aged 59 and 53 years, presented with a history of several months of classical fever of unknown origin (FUO), largely normal physical findings, and elevated markers of systemic inflammation.

INVESTIGATIONS:

After initially unremarkable findings, duplex-sonography detected circular, hypoechogenic wall thickening of the axillary arteries without hemodynamically significant narrowing of the lumen. 18F-fluorodeoxyglucose positrone emission-tomography (18F-FDG-PET) revealed marked vascular tracer uptake in the aorta and in the proximal arteries of the arms and legs. TREATMENT AND FOLLOW-UP: The diagnosis of Takayasu's arteritis was made, and high-dose prednisone treatment was initiated. Within a few days both patients became asymptomatic.

CONCLUSIONS:

Large vessel vasculitis is a known cause of FUO. Duplex-sonography and 18F-FDG-PET are able to detect these disorders at an early stage before the onset of clinically relevant arterial obstructions. More widespread use of these techniques may show that large-vessel vasculitis is more common than previously thought.

• Authors: F Tatò, M Weiss, U Hoffmann
• Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr) Vol. 131 Issue 31-32 Pg. 1727-30 (Aug 04 2006) ISSN: 0012-0472 [Print] Germany
• Vernacular Title: Takayasu-Arteriitis ohne manifeste Gefässstenosen als Ursache von Fieber unklarer Genese.
• PMID: 16868876 (Publication Type: Case Reports, Journal Article)

Chemical References

• Radiopharmaceuticals
• Fluorodeoxyglucose F18
• Prednisone

Topics

• Arterial Occlusive Diseases
• Female
• Fever of Unknown Origin (etiology)
• Fluorodeoxyglucose F18
• Humans
• Inflammation
• Middle Aged
• Prednisone (therapeutic use)
• Radionuclide Imaging
• Radiopharmaceuticals
• Takayasu Arteritis (diagnosis, diagnostic imaging, drug therapy)