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Well-imaged large vessel vasculitis attributed to anticardiolipin antibody
W N Roberts1, J H DeMeo, S A Breitbach
1Medical College of Virginia/Virginia Commonwealth University, Richmond.
Objective:
We report a case of large vessel vasculitis, compare imaging techniques, and briefly review the literature.
Methods:
Anticardiolipin antibody titers, acute-phase response, and ischemic symptoms in a 50-year-old man admitted for treatment of vasculitis-related ischemia of the fingers were monitored over a 14-month period. Images from serial magnetic resonance angiography (MRA) were compared with images from conventional arteriography in the evaluation of peripheral arterial circulation.
Results:
The acute-phase response and anticardiolipin antibody levels were found to vary in parallel with slow resolution of ischemic symptoms following monthly treatment with pulse methylprednisolone and cyclophosphamide.
Conclusion:
Attribution of ischemic symptoms to anticardiolipin antibody is supported by the correlation of anticardiolipin antibody titers, acute-phase response parameters, and ischemic symptoms. The serial images from MRA demonstrate its usefulness as a noninvasive tool for followup studies of both large and medium-sized vessels affected by vasculitis.