Fluoroquinolone-Associated Type A Aortic Dissection in Alpha-1 Anti-Trypsin Deficiency

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Genetics

Background:

• Fluroquinolone antibiotics (FQ) are associated with aortic events, prompting cautious use in patients with known aortopathy.
• Existing guidelines recommend caution for patients with Marfan and Ehlers-Danlos syndromes.
• Other at-risk populations may not be fully recognized.

Observation:

• A patient with alpha-1 anti-trypsin (A1AT) deficiency presented with a delayed type A aortic dissection.
• The patient had a history of prolonged exposure to FQ antibiotics.
• This presentation was considered atypical for the patient's underlying condition.

Findings:

• This case report details an unusual delayed presentation of type A aortic dissection.
• The patient's A1AT deficiency and FQ exposure are key factors in this case.
• The findings suggest a potential link between FQ use and aortic dissection in A1AT deficiency.

Implications:

• Prescribing fluroquinolones requires careful consideration in patients with A1AT deficiency.
• Expanded caution for FQ use may be warranted beyond currently recognized at-risk groups.
• Further research is needed to elucidate the mechanism linking FQ, A1AT deficiency, and aortic dissection.