[Aortitis: report of three cases].

Area of Science:

• Cardiovascular Medicine
• Rheumatology
• Immunology

Background:

• Aortitis, inflammation of the aortic wall, encompasses diverse etiologies including inflammatory, infectious, paraneoplastic, and idiopathic diseases.
• Diagnosis often necessitates a high clinical suspicion due to variable and nonspecific symptoms, frequently being an incidental finding.
• Imaging studies are crucial for confirming the diagnosis of aortitis.

Observation:

• Case 1: A 29-year-old woman with alopecia, oral/nasal ulcers, and positive antinuclear antibodies presented with thoracic aorta thickening, dilation, and stenosis.
• Case 2: A 41-year-old male with dorsal pain and cough showed descending aorta thickening and celiac artery stenosis, diagnosed as polyangiitis.
• Case 3: A 28-year-old woman with upper abdominal pain exhibited aortic arch and subclavian artery thickening, diagnosed as sarcoidosis.

Findings:

• Successful treatment in Case 1 involved steroids, hydroxychloroquine, cyclophosphamide, and azathioprine.
• Cases 2 and 3 were managed with corticosteroids and immunosuppressants (cyclophosphamide, azathioprine) tailored to their specific diagnoses.
• These cases illustrate the varied clinical presentations and successful management of different forms of aortitis.

Implications:

• Highlights the importance of considering aortitis in patients with unexplained systemic symptoms and vascular abnormalities.
• Demonstrates the efficacy of multimodal immunosuppressive therapy in managing diverse aortitis presentations.
• Emphasizes the role of advanced imaging in diagnosing and characterizing aortic inflammation and its complications.