Ankylosing spondylitis and an aortic arch syndrome

Area of Science:

• Rheumatology
• Vascular Medicine
• Immunology

Background:

• Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton.
• Peripheral joint involvement and extra-articular manifestations are common in AS.
• Large vessel arteritis is an uncommon but serious complication of spondyloarthropathies.

Observation:

• A 63-year-old woman with a 16-year history of AS and peripheral arthritis was evaluated.
• The patient presented with symptoms suggestive of large vessel involvement.
• Imaging revealed arteritis affecting the branches of the aortic arch.

Findings:

• The patient was diagnosed with large vessel arteritis.
• The arteritis specifically involved the aorta's arch branches.
• This represents a significant extra-articular manifestation of her long-standing ankylosing spondylitis.

Implications:

• This case underscores the potential for systemic vascular complications in patients with ankylosing spondylitis.
• Early recognition and management of large vessel arteritis are crucial for preventing severe outcomes.
• Further research into the pathogenesis and optimal treatment strategies for AS-associated vasculitis is warranted.